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UPDATED: Sat, 11/10/2007 - 10:55pm

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Will I Always Have Epilepsy?

About 80% of people with epilepsy treated with seizure medicines remain free of seizures for at least 2 years. Many never have any more seizures. The chances of becoming completely seizure-free are best if there is no known brain injury or abnormality, and if the person has a normal neurological examination and EEG.

Of adults, 50-60% will be seizure-free after using their first seizure medicine. Another 11-20% will gain seizure control using the second medication, leaving 20-30% who are still having seizures.

Among those who are young when their epilepsy is diagnosed, 20% start on medication and never have another seizure after medication is stopped, even when they reach adulthood. About 50-60% of children become seizure-free with the first medication used, but 30% never stop taking seizure medicines. About 10% have a really difficult time with “intractable seizures.”

The more time that passes without seizures, the greater is the chance of staying seizure-free. Over 50% of children outgrow their epilepsy. Twenty years after the diagnosis, three-quarters of people will have been seizure-free for at least 5 years, although some may still need to take daily medication.

Will I have to take seizure medicines for the rest of my life?

Many people who are seizure-free for 2 to 4 years can stop taking their medications, under their doctor's supervision, without having further seizures. However, about 30% of children and 30% to 65% of adults will have seizures again. You need to discuss this with your neurologist and, if the decision is made to go off medication, agree on a plan for stopping gradually over weeks or months, not all at once. Currently, most neurologists in the United States and Canada consider withdrawing seizure medicines after someone has been seizure-free for 1 to 2 years.

Whether it will be safe for you to stop taking your seizure medicine depends partly on whether you drive a car or engage in other activities that would be dangerous if you had another seizure. If your answer is "yes," you will need to be more cautious.

I've been taking seizure medicine but I'm still having seizures. Will I always have them?

Some people with seizures that cannot be controlled with tolerable doses of seizure medicine (who have what doctors call "intractable epilepsy") do eventually become seizure-free. The longer that you continue to have seizures after the diagnosis of epilepsy is made, however, the lower the chance that your seizures will stop.

Your doctor will want you to try different medications or combinations of them. The more medicines that are unable to control your seizures, however, the less likely it is that another medication regimen will fully succeed. Other kinds of treatments, such as vagus nerve stimulation or epilepsy surgery, may be very helpful for some people who continue to have seizures while taking seizure medicines.

Topic Editor: Steven C. Schachter, M.D.
Last Reviewed:12/15/06

Continue to: How serious are seizures?


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