Specialist Treatment Options
Non-Drug Treatments
Surgery, dietary therapy and stimulation treatments may be options for some people with epilepsy. A specialist team can help you understand which approaches are appropriate for your circumstances.
About this information: This webpage is subject to continuous review by Epilepsy South Central Ontario to help keep the information current. Updates to linked pages may be in progress. This material is for informational purposes only and should not be used for self-diagnosis or as a substitute for professional medical advice, diagnosis or treatment. Consult your healthcare provider about your own health and care.
Non-drug does not mean medication-free. These treatments may be used alongside anti-seizure medication. Do not change your prescription without medical guidance.
Timely Assessment Matters
When should you ask about specialist review?
If seizures continue despite treatment, ask your clinician whether referral to a comprehensive epilepsy centre is appropriate. In particular, discuss referral after adequate trials of two appropriately chosen, tolerated and used medication schedules have not achieved sustained seizure freedom.
You do not need to try every available medicine or every non-drug treatment before asking about surgical evaluation. An assessment can also help identify options for someone who does not have surgery.
Treatment Options
Explore the main approaches.
The decision depends on your epilepsy, test results, overall health, goals and the benefits and risks of each option.
Surgical Assessment
Surgery
Different procedures may aim to achieve seizure freedom or reduce seizure burden. A specialist evaluation considers where seizures arise and whether an operation could help.
A referral does not commit you to surgery. Your team should explain the available options, likely outcomes and individual risks.
Medical Dietary Treatment
Ketogenic Diet Therapy
Specialist dietary therapies may help some children and adults. They require assessment, education and monitoring by a trained clinical team, including a dietitian.
Do not attempt ketogenic dietary therapy independently. A medical epilepsy diet is different from following a general weight-loss diet.
Nerve Stimulation
Vagus Nerve Stimulation
VNS uses an implanted device to deliver electrical stimulation through the vagus nerve. It may be considered as an additional treatment for some people with drug-resistant epilepsy.
Assessment, device programming and ongoing follow-up are part of treatment. Benefits vary between people.
Brain Stimulation
Deep Brain Stimulation Therapy
DBS uses surgically implanted electrodes to deliver electrical stimulation to selected brain regions. It may be considered for some people with drug-resistant epilepsy following specialist assessment.
Ask your epilepsy team about suitability, availability, expected benefits, surgical risks and follow-up. DBS does not guarantee seizure freedom.
These options are not a fixed sequence.
Dietary therapy and stimulation are not simply steps everyone must complete before surgery. Equally, surgery is not appropriate for everyone. Your specialist team can explain how different options fit your situation and whether they can be combined.
Make an Informed Decision
Questions for your specialist team.
Benefits & risks
- What is the goal of this treatment for me?
- What improvement is realistic, and over what timeframe?
- What are the short- and long-term risks?
- What happens if it does not help?
Everyday practicalities
- Which tests or referrals are needed?
- Will I continue my current medication?
- What follow-up, recovery or monitoring is involved?
- What support, travel or costs should I plan for?
Support for the whole person.
Medical treatment is one part of living with epilepsy. Ask about support for mood, memory, learning, relationships and daily life alongside seizure management.
Epilepsy South Central Ontario can explain available community programs and resources.
Non-Drug Treatment Education Video
This existing video is retained for general education. Discuss current recommendations and options with your healthcare team.
Further reading:
ILAE: Drug-Resistant Epilepsy ·
ILAE: Epilepsy Surgery.