There is no cure for epilepsy, yet. The main treatment options for people with epilepsy are medications, surgery and vagus nerve stimulation. The ketogenic diet is also an option for some children, and increasingly, for some adults. Investigational treatments may also be an option for eligible patients.
The same treatment does not work for every patient because the type and severity of epilepsy varies. Also, due to the complexity of women's hormones which can both affect and be affected by seizures and medications, there are some special considerations in planning treatment for women. These considerations depend on the patient's stage in life, reproductive plans, and on individual differences.

Medications:
Medications do not cure epilepsy in the same sense that penicillin can cure an infection, however antiepileptic drugs successfully prevent seizures in the majority of people who take them regularly and as prescribed. It has been estimated that at least fifty percent of all patients with epilepsy gain complete control of their seizures for substantial periods of time. Another thirty percent enjoy a significant reduction in the number of seizures. If patients, in collaboration with their physicians, decide to attempt withdrawal from medications, they should be aware that the seizures may recur and should closely observe seizure precautions. Some individuals, however, have an excellent chance of remaining seizure free without medication in the future.
Unfortunately, some people continue to have seizures regularly despite taking medication. There is hope that continuing research will produce new drugs, and new ways of using them, that will eventually give seizure relief to everyone who has epilepsy.

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Surgery:
Surgery for epilepsy is a delicate, complicated operation. It is usually done at special medical centers that treat patients with epilepsy rather than at local hospitals.
In addition to operations that remove a small part of the brain where seizures begin, other procedures may be done to interrupt the spread of electrical energy in the brain.
People who are going to have epilepsy surgery may have several special tests first. In some cases, electrodes have to be implanted in a separate operation to locate seizure sites deep in the brain. Sometimes these tests take days or even weeks to complete. In some cases, the patient may be awake during part of the operation (this is not usually the case with small children.) This is possible because the brain does not feel pain. Having the patient awake helps the doctors make sure that important parts of the brain are not damaged.
Afterwards, some seizure medications may have to be continued, usually for a year or two. Then, if no further seizures occur, the medicine may be slowly withdrawn. At this point, chances of living free of seizures and free of medication are good, however many people will have to continue with medication and some do not benefit from surgery.

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Vagus Nerve Stimulation:
Vagus nerve stimulation therapy is another form of treatment that may be tried when medications fail to stop seizures. It is currently approved for use in adults and children over the age of 12 who have partial seizures that resist control by other methods. The therapy is designed to prevent seizures by sending regular small pulses of electrical energy to the brain via the vagus nerve, a large nerve in the neck.
The energy is delivered by a battery which is surgically implanted in the chest wall. Electrodes are threaded under the skin and wound around the vagus nerve in the neck. The battery is programmed by the health team to send a few seconds of electrical energy to the vagus nerve every few minutes. If the person with the system feels a seizure coming on, he or she can activate the discharge by passing a small magnet over the battery. In some people, this has the effect of stopping the seizure.
Side effects of VNS therapy are mostly hoarseness or discomfort in the throat. Although complete seizure control is seldom achieved, the majority of people who use VNS therapy experience fewer seizures. In some its effectiveness increases with time, and patients report an improved quality of life. It will almost always be necessary to continue anti-epileptic medication although the patient should be able to take less medication than in the past.

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Ketogenic Diet:
Our bodies run on energy from glucose which we get from food. But we can't store large amounts of glucose: we only have about a 24-hour supply. When a child uses up all the stored glucose, the body begins to burn stored fat. The ketogenic diet keeps this process going. It forces the child's body to burn fat round the clock by keeping calories low and making fat products the primary food that the child is getting. In fact, the diet gets most (80 percent) of its calories from fat. The rest comes from carbohydrates and protein. Each meal has about four times as much fat as protein or carbohydrate. Trying to put a child on the diet without medical guidance puts a child at risk of serious consequences. Every step of the ketogenic diet process must be managed by an experienced treatment team, usually based at a specialized medical center.
The amounts of food and liquid at each meal have to be carefully worked out and weighed for each person. Doctors don't know precisely why a diet that mimics starvation by burning fat for energy should prevent seizures, although this is being studied. Nor do they know why the same diet works for some children and not for others.
About a third of children who try the ketogenic diet become seizure free, or almost seizure free. Another third improve but still have some seizures. The rest either do not respond at all or find it too hard to continue with the diet, either because of side effects or because they can't tolerate the food.
Most experts say the diet is worth trying when two or more medications have failed to control seizures, or when medications cause side effects that are having a harmful effect on a child's life. It also helps to have a child who is willing to try foods that he might otherwise not be enthusiastic about, and is tolerant and not fussy about eating.
Adult women on the diet may have menstrual irregularities. Pancreatitis (inflammation of the pancreas), decreased bone density and certain eye problems have also been reported. Again, this is why the medical team closely follows children or adults who are on the diet. The diet lacks several important vitamins which have to be added through supplements. Sometimes high levels of fat build up in the blood, especially if a child has an inborn defect in his ability to process fat. This possibility can lead to serious effects, which is another reason for careful monitoring.