Treatment methods

Holistic therapy – individually tailored to your needs

Depending on the type of epilepsy, the course of the disease and the situation of the family, we offer you various therapy options: from medication to surgical and psychotherapeutic treatment to counselling and training. 

Together with you, our consultants set realistic treatment goals in order to avoid disappointment. Possible therapy goals include freedom from seizures, less frequent seizures, no injuries, fewer restrictions in everyday life and an improvement in quality of life.

Conservative treatment methods

Drug treatment

One often does not know when the seizures will occur and, whenever they do occur, it sometimes happens very quickly. That is why it is usually not possible to take targeted epilepsy medication. You must take your medication regularly on every day of the year, even if you only had a seizure on five or ten days.

The choice of your medication depends on several factors:

  • Type of seizure
  • Form of epilepsy
  • Cause of epilepsy
  • Age 
  • Tolerance of the drug
  • Pre- or concomitant diseases
  • Treatment already performed

It sometimes takes a few weeks or even months until a reliable effect is achieved. The effectiveness of many drugs is also dose-dependent. If you finally have no seizures, you should continue to take the medication for at least another one to two years.

“Emergency medication”

Epileptic seizures usually stop on their own. However, there are also drugs that can be used in emergencies. 

Possible emergencies:

  • Seizures that last longer than three minutes
  • Focal seizures attacks that do not subside after ten minutes
  • Seizure series depending on individual experience
  • Seizure status

Fewer seizures due to special nutrition

Reducing epileptic seizures by changing the diet? This is actually possible with the help of a ketogenic diet or a modified Atkins diet. The diet is switched to higher-fat, carbohydrate-reduced products. Anyone who thinks now of sausages, roasts and burgers is wrong. The ketogenic diet is the exact opposite. Predominantly healthy fats are used. This not only reduces the number of epileptic seizures, but also improves your nutritional status. At the same time, the change in diet can reduce medication or sometimes even make it unnecessary. 

Bringing the seizure under control with psychotherapy

Behavioural strategies are usually used in addition to your drug therapy and are usually paid for by your health insurance. Psychotherapeutic treatment specifically promotes “seizure self-control” and can help you to reduce conflicts and fears and to develop more effective behaviour patterns for difficult situations. You will gradually learn to cope better with your illness. The psychological relief can lead to a significant improvement in the seizure situation, especially by alleviating the fear of the illness. Sometimes, the handling of the medication also improves, so that its effectiveness is increased.

Components of the therapy:

The therapy focuses on the handling of seizure triggers and seizure-promoting factors as well as the interruption of aura-induced seizures.

  • The seizure diary
    For some people, certain triggers, such as a shock or flickering light, almost always lead to a seizure. Some factors that promote seizures only increase the probability of a seizure in combination: Here, for example, a shock only leads to a seizure if there is additional tension or fatigue. In order to reliably discover such relationships, precise observation is required, preferably in the form of a diary. Here, you record which factors promote your seizures, but also in which situations seizures rarely or never occur. These “stable life situations” are very important for the treatment. They show ways of better handling seizure-promoting situations and thus reduce the fear of seizures. 
  • Preventing seizures
    Once we have identified the factors that promote the seizure, we work with you to develop a health-promoting approach to these situations. You can avoid seizure triggers such as flickering light, for example, by wearing dark glasses. Factors such as a shock or changes in the weather are unavoidable. However, if you have discovered that additional risk factors, such as lack of sleep or stress, play a role, you can try to influence them. Feelings like stress, anger or joy cannot be avoided, but you can learn to deal with them differently. 
  • The aura interruption
    If the seizure begins with an aura, there is another way to ward off the seizure: by interrupting the aura.
    The basic rule for an effective “antidote” is that the “opposite” of the seizure symptoms should be attempted: An “epileptic tingling sensation” is countered by rubbing the affected part of the body, a strange taste in the mouth can be interrupted by taking a pinch of salt, and when the colour red is suddenly and intensively perceived, the colour green is intensively thought of. The antidote specifically activates the nerve cells adjacent to the epileptic focus and thus prevents the spread of seizure activity in the brain. This interrupts or postpones the seizure so that you gain time to get to safety.
  • The interruption of the seizure
    The development of seizure interruption strategies can be supported by EEG biofeedback techniques. You will learn to create an awake and relaxed state of your brain that is not compatible with epileptic seizure activity.

Surgical treatment methods

Surgical therapy

After detailed preliminary examinations, an operation can become useful if the following conditions are present:

  • At least two medications have not worked sufficiently
  • The cause of epilepsy is tissue change in the brain, such as a tumour, a scar, a malformation of the cerebral cortex or a vascular malformation
  • The seizures originate in the brain. There are no important functions at this place of origin or in its immediate vicinity
  • Tissue removal is possible without the risk of major brain injury

During the operation, the brain section with the pathological changes is identified and then surgically removed. Two years after the operation, an attempt is made to reduce the medication.

Treatment with electrical impulses: vagus nerve stimulation

If drug therapy has not helped and surgical removal of the diseased area is not possible, there is another option: what is known as the vagus nerve stimulator. This electrical device, the size of a matchbox, is placed in a skin fold below the clavicle during an outpatient procedure. The stimulator then sends electrical impulses via a fine wire to the cranial nerve, the vagus nerve, which transmits them to the brain. The duration, strength and frequency of the stimuli must be gradually adjusted during the subsequent treatment in order to achieve the best effect on the seizures.

If you feel warning signs before a seizure, you can use a magnet to specifically turn the device on. Some seizures can be interrupted in this way. 

Vagus nerve stimulation significantly reduces seizures. A positive influence on depressive moods has also been reported in many cases. Therapy with medications is still maintained. After about seven to 12 years, another intervention is required to change the battery.

“Of course, it is usually easier and much less time-consuming to treat a patient with medication than to change his diet. However, it is worth it in many cases.” 
Prof. Dr. Gerhard Kluger