If the first few seizure medicines you try don’t control your seizures, chances are that another medicine won’t work well either. When your epilepsy doesn’t respond to the first 2 medicines that were the right kind for your seizure type, it’s called drug resistant epilepsy

What are my other options?

If you’ve tried 2 or more seizure medicines and you’re still having seizures, it’s time to get more help from an epilepsy specialist. This means seeing a neurologist who specializes in epilepsy — also called an epileptologist ("ep-i-lept-AH-luh-gist").

Ask for a referral to an epilepsy center.

Epilepsy centers are health care programs that focus on caring for people with seizures and epilepsy. You would first meet with an epileptologist. You also may see nurses, surgeons, neuropsychologists, social workers, and other health care professionals. They can help sort out what’s going on, what treatments may help you, and how the epilepsy is affecting your life and your loved ones. Find an epilepsy center near you.

What may be done at an epilepsy center? First, you’ll need tests to find out as much as possible about your epilepsy. Then you and your health care team can talk about your options, including:

  • Newer seizure medicines. Even if the chances are low that other medicines may work, every person is different! You may just need to find the right combination that will control your seizures without causing bad side effects. Learn more about seizure medicines.
  • Surgery. If your seizures start from one area of your brain, doctors can sometimes do surgery to remove that part of your brain. If that type of surgery is right for you, it could help control or cure your epilepsy. There are other types of epilepsy surgery that may help if your seizures happen in large or multiple areas of your brain. Learn more about epilepsy surgery.
  • Dietary Therapy. Some special diets can help control seizures. These include the ketogenic diet, the modified Atkins diet, and the low glycemic index diet. If you and your health care team decide on dietary therapy, your epilepsy specialist will prescribe the diet, and a nutritionist will help you plan what to eat. Dietary treatment may work in people who don’t respond to medicine, but most people on a diet treatment still take seizure medicines. Learn more about dietary therapies.
  • Vagus nerve therapy. Devices are a growing area of epilepsy treatment. Vagus nerve stimulation, called VNS Therapy™, is a device treatment that can help treat seizures that don’t respond to medicines. Learn more about vagus nerve therapy.
  • Responsive neurostimulation:  The Neuropace RNS® System is another type of device for people with seizures that don’t respond to medications or surgery, or when surgery isn’t right for a person. Learn more about responsive neurostimulation.
  • Other types of brain stimulation or surgery. Other device treatments are currently being tested, such as Deep Brain Stimulation, as well as new types of surgery, like thermal ablation (Visualase®).
  • Behavioral therapies. Sometimes people need more than just medicine, surgery, or a device. Behavioral (or non-drug treatments) may help control seizures or other problems that can happen with epilepsy. These treatments are complementary, meaning they are usually used along with seizure medicine or other treatments. Learn more about complementary health approaches.
  • Research studies. If your seizures don’t respond to medicine and other treatments like surgery aren’t right for you, consider joining a research study. There are many different studies looking at how to treat seizures better. While these studies may not help you directly, they may lead to answers that will help you and others later on. Learn more about clinical trials and research.  

How do I know what’s right for me? 

There’s not one treatment that’s right for everyone. Talk to your epilepsy team about the benefits and risks of different treatment options. Together, you and your team can figure out what’s right for you.

Authored By: 
Patricia O. Shafer RN, MN
Authored Date: 
Reviewed By: 
Joseph I. Sirven MD
Tuesday, October 28, 2014