Epilepsy may mean the patient is harboring a brain tumor or vascular malformation. An MRI study is recommended early on the management of epilepsy so that surgery can be performed as soon as possible if such a lesion is present. Modern MRI techniques will reveal tumors or other lesions even when they are very small. For the majority of epilepsy patients seizures can be fully controlled by daily medications. Antiepileptic drugs act on the brain cells to make them less likely to fire.
Modern drugs continue to be developed for treating various types of seizures.
However, in some patients seizures are not well controlled even after trying a number of drugs, or the medications may have side effects that are not well tolerated. Surgery should be considered in these cases. It is recommended that patients wait only a few years to try various epilepsy medications before evaluation for surgery. Delay only results in further hardships for the patient and family, sometimes with lasting effects, especially for youngsters in school or starting their careers. Surgery is a well-established approach to treating epilepsy.