You’ve just received an epilepsy diagnosis. Now what?

woman stretches arms in bed on sunny day 
Well, the first thing to know is that you’re not alone, as 1 in 26 people in the United States have epilepsy.  With more than 20 anti-seizure medications available, more than two-thirds of people can have seizures controlled with medication, along with lifestyle changes.
 
What are some lifestyle changes that help control epileptic seizures?
 
  1. It goes without saying that to treat epilepsy successfully you should always take your anti-seizure medication on time. Yet it’s known that for chronic diseases the adherence rate for medication is only about 50%. To take medications on a regular basis with no missed dosages you need to have a system. One of the best systems is to use an inexpensive pill organizer. Pill organizers have a compartment for each day of the week. Electronic reminders using smartphones can also be helpful. 
  2. Sleep health is another important factor. Sleep health consists of duration and quality. About one-third of people in the U.S. get less than seven hours of sleep each night. Sleep quality depends on sleep that fits your circadian or body rhythms. You should wake up at the same time every morning and go to bed at a time that would allow at least seven hours of sleep. You should also dim indoor lighting and slow your life and mind down about one hour before bedtime. Don’t watch television or use electronics in bed. A common sleep problem, especially in men, is sleep apnea. If someone has snoring and daytime drowsiness or fatigue, sleep apnea should be considered. Testing for sleep apnea is now easier, as home sleep studies are available.  
  3. Avoiding seizure triggers such as flashing lights and video games played in the dark is essential for controlling certain kinds of epileptic seizures. Some medications can trigger seizures, including over-the-counter sleeping medications, newer antibiotics and antidepressants.  Bupropion, an antidepressant also used to help people stop smoking, may trigger seizures in some people. 
  4. Exercise improves energy, mood and helps relieve stress. Since stress is a common trigger for seizures and regular exercise reduces stress, exercise may reduce the number of seizures. Be sure to talk to your neurologist to see what types of exercise would be safe for you. A study from Norway of exercise in women with uncontrolled seizures showed that regular exercise led to a significant reduction in the number of seizures. 
 
What are the options if I’m still having seizures despite significant lifestyle changes? 
 
If, after trying two or three anti-seizure medications, your seizures remain poorly controlled, your neurologist may want to admit you to an epilepsy monitoring unit in a hospital to record a seizure on video and EEG. This is to make sure you’re actually having epileptic seizures, since some seizures are non-epileptic and can’t be treated with anti-seizure medication. 
 
Non-epileptic seizures are often related to early traumatic childhood experiences and may require counseling. Also, admission to an epilepsy monitoring unit may clarify the epileptic seizure type and determine if you might be a candidate for epilepsy surgery or an implantable device. In the last 10 years, there have been important advances in epilepsy surgery and devices that may reduce or completely control epileptic seizures. 
 
For a useful resource, visit The Epilepsy Foundation. 
 
William Bell is director of the Division of Epilepsy at The Ohio State University Wexner Medical Center and a professor of neurology at The Ohio State University College of Medicine.