Epilepsy Management: Taking Control of Seizures

Living with epilepsy means learning to manage a condition that can be unpredictable. But with the right strategies, support, and treatment, most people with epilepsy lead full, active lives. This guide will help you understand how to take control of your seizure management.

Understanding Epilepsy

Epilepsy is a neurological condition characterized by recurrent seizures. A seizure is a sudden surge of electrical activity in the brain that can cause changes in behavior, movement, feelings, or consciousness.

Types of Seizures

Focal Seizures Start in one area of the brain:

May cause unusual sensations or feelings
Can involve automatisms (repetitive movements)
May or may not affect awareness

Generalized Seizures Involve both sides of the brain:

Absence seizures – brief staring spells
Tonic-clonic seizures – convulsions with loss of consciousness
Atonic seizures – sudden loss of muscle tone
Myoclonic seizures – brief muscle jerks

The Goal of Treatment

The primary goal is seizure freedom with minimal side effects. About 70% of people with epilepsy can achieve good seizure control with proper treatment. For others, reducing seizure frequency and severity remains an important goal.

Medication Adherence

Antiseizure medications (ASMs) are the foundation of epilepsy treatment. Taking them consistently is one of the most important things you can do.

Why Adherence Matters

Keeps medication levels steady in your bloodstream
Prevents breakthrough seizures
Helps your doctor assess treatment effectiveness
May prevent status epilepticus (prolonged seizures)

Strategies for Success

Establish a Routine

Take medications at the same times each day
Link to daily habits (meals, brushing teeth)
Set phone alarms or use medication reminder apps

Organize Your Medications

Use a weekly pill organizer
Keep medications visible but away from children
Refill before you run out
Keep a list of all medications and dosages

Travel and Backup Plans

Always carry extra medication
Keep medications in carry-on luggage when flying
Know how to get refills when traveling
Carry a copy of your prescriptions

Managing Side Effects

Common side effects may include:

Drowsiness or fatigue
Dizziness
Weight changes
Mood changes
Cognitive effects

Tips:

Give your body time to adjust to new medications
Take with food if stomach upset occurs
Don't stop medications suddenly – this can trigger seizures
Report side effects to your doctor – dose adjustments or medication changes may help

Drug Interactions

Some things that can interact with ASMs:

Other medications (including over-the-counter and herbal supplements)
Grapefruit juice (affects some medications)
Alcohol (can affect seizure threshold and medication levels)
Birth control pills (some ASMs reduce effectiveness)

Always check with your doctor or pharmacist before starting new medications or supplements.

Identifying and Managing Triggers

While seizures can occur without warning, many people have identifiable triggers that can increase seizure likelihood.

Common Seizure Triggers

Sleep-Related

Sleep deprivation
Irregular sleep patterns
Sleep disorders (apnea)

Lifestyle Factors

Alcohol consumption
Drug use
Missed medications
Extreme stress

Physiological Factors

Illness and fever
Hormonal changes (menstrual cycle)
Low blood sugar
Dehydration

Environmental Factors

Flashing lights (photosensitivity affects about 3% of people with epilepsy)
Patterns and visual stimulation
Extreme temperatures

Your Seizure Diary

Keep track of:

Date and time of seizures
What you were doing before the seizure
Sleep patterns
Stress levels
Missed medications
Illness or other health issues
Alcohol or drug use
Menstrual cycle (if applicable)

This information helps identify patterns and triggers specific to you.

Trigger Management Strategies

Sleep Hygiene

Maintain a regular sleep schedule
Create a restful sleep environment
Avoid screens before bed
Address sleep disorders with your doctor

Stress Management

Practice relaxation techniques
Regular exercise (with precautions)
Counseling or therapy
Time management strategies

Healthy Habits

Eat regular, balanced meals
Stay hydrated
Limit or avoid alcohol
Manage overall health conditions

Seizure Preparedness

Being prepared can help you feel more confident and ensure safety during seizures.

Seizure Action Plan

Work with your healthcare team to create a written plan including:

Your seizure types and typical patterns
When to give rescue medications (if prescribed)
When to call for emergency help
Emergency contact information
Your medication list

Share this plan with family, friends, coworkers, and teachers.

Rescue Medications

For some people, doctors prescribe rescue medications to stop prolonged or clustered seizures:

Usually benzodiazepines (like diazepam or lorazepam)
Different forms: nasal spray, rectal gel, or oral
Training required for caregivers on proper administration
Know when to use and when to call 911

Safety Precautions

At Home

Pad sharp corners on furniture
Avoid glass tables or shower doors
Use the microwave instead of the stove when possible
Shower instead of bathing; use shower chairs
Carpeted floors are safer than hard surfaces

In Public

Carry medical identification
Tell trusted people about your epilepsy
Know your warning signs (auras) if you have them
Sit near aisles in theaters or on transportation

Water Safety

Never swim alone
Swim with a buddy who knows about your epilepsy
Avoid depths where you couldn't stand if needed
Consider a life jacket for water activities

Lifestyle Considerations

Exercise and Sports

Most people with epilepsy can participate in sports and exercise with appropriate precautions:

Generally Safe:

Walking, jogging, hiking
Swimming (with supervision)
Team sports
Yoga, tai chi

Take Extra Precautions:

Cycling (wear a helmet)
Water sports (life jacket, buddy)
Climbing (safety harness)

Discuss with Your Doctor:

Contact sports
Skydiving, scuba diving
High-altitude activities

Regular exercise can actually help reduce seizures by improving overall health and reducing stress.

Work and Career

Considerations:

Most jobs are open to people with epilepsy
Some restrictions may apply (commercial driving, operating heavy machinery, certain military roles)
You may choose whether to disclose your epilepsy to employers
Workplace accommodations may be available

Know Your Rights:

The Americans with Disabilities Act (ADA) protects against discrimination
Reasonable accommodations must be provided
You cannot be fired for having epilepsy if you can perform essential job functions

Pregnancy and Family Planning

Important considerations:

Most women with epilepsy have healthy pregnancies
Some ASMs can affect birth control effectiveness
Some ASMs carry risks during pregnancy
Plan ahead – meet with your neurologist and obstetrician before trying to conceive
Folic acid supplementation is important
Don't stop medications without medical guidance

Emotional and Social Well-being

The Emotional Impact

Living with epilepsy can bring challenges:

Anxiety about when the next seizure will occur
Depression (more common in people with epilepsy)
Frustration with limitations or side effects
Fear of social stigma
Grief over loss of independence or changes in lifestyle

Building Resilience

Connect with Others

Join an epilepsy support group
Online communities can provide connection
Share experiences with others who understand

Professional Support

Counseling or therapy
Consider evaluation if depression or anxiety is persistent
Neuropsychological assessment if cognitive concerns arise

Education is Empowering

Learn about your specific type of epilepsy
Understand your treatment options
Knowledge helps reduce fear and uncertainty

Addressing Stigma

Unfortunately, misconceptions about epilepsy still exist:

Educate others when appropriate
Be open about your needs
Advocate for yourself
Remember that epilepsy is a medical condition, not something to be ashamed of

When to Seek Help

Contact Your Doctor If:

Seizure patterns change
Seizures increase in frequency
You experience new types of seizures
Side effects are bothersome
You're planning pregnancy
Your mood is persistently low or anxious

Seek Emergency Care If:

A seizure lasts longer than 5 minutes
Multiple seizures occur without recovery between them
Injury occurs during a seizure
Breathing is difficult after a seizure
It's your first seizure
Seizure occurs in water

Moving Forward

Epilepsy is a part of your life, but it doesn't have to define you. With proper management, most people with epilepsy:

Achieve good seizure control
Maintain fulfilling relationships
Pursue education and careers
Participate in activities they enjoy
Live independently

The key is becoming an active partner in your care – learning about your condition, working closely with your healthcare team, and making choices that support your overall health and well-being.

This guide provides general information about epilepsy management. Always follow your neurologist's specific recommendations for your situation.