The International League Against Epilepsy created a task force on women and epilepsy which published consensus recommendations to guide therapy decisions until more definitive evidence is available in the future. Alternative medicine
Alternative medicine, including acupuncture, routine vitamins, and yoga, have no reliable evidence to support their use in epilepsy. Melatonin, as of 2016, is insufficiently supported by evidence. The trials were of poor methodological quality and it was not possible to draw any definitive conclusions.Several supplements (with varied reliabilities of evidence) have been reported to be helpful for drug-resistant epilepsy. These include high-dose Omega-3, berberine, Manuka honey, Reishi and Lions Mane mushrooms, curcumin, vitamin E, coenzyme Q-10, and resveratrol. The reason these can work(in theory) is that they reduce inflammation or oxidative stress, two of the major mechanism contributing to epilepsy. Prognosis
Epilepsy cannot usually be cured, but medication can control seizures effectively in about 70% of cases. Of those with generalized seizures, more than 80% can be well controlled with medications while this is true in only 50% of people with focal seizures. One predictor of long-term outcome is the number of seizures that occur in the first six months. Other factors increasing the risk of a poor outcome include little response to the initial treatment, generalized seizures, a family history of epilepsy, psychiatric problems, and waves on the EEG representing generalized epileptiform activity. In the developing world, 75% of people are either untreated or not appropriately treated. In Africa, 90% do not get treatment.
Despite this, treatment is often continued once effective, because the risk of untreated epilepsy is believed to be greater than the risk of the medications. Among the antiepileptic medications, levetiracetam and lamotrigine seem to carry the lowest risk of causing birth defects.Slowly stopping medications may be reasonable in some people who do not have a seizure for two to four years; however, around a third of people have a recurrence, most often during the first six months. Stopping is possible in about 70% of children and 60% of adults. Measuring medication levels is not generally needed in those whose seizures are well controlled. Surgery
Epilepsy surgery may be an option for people with focal seizures that remain a problem despite other treatments. These other treatments include at least a trial of two or three medications. The goal of surgery is total control of seizures and this may be achieved in 60–70% of cases. Common procedures include cutting out the hippocampus via an anterior temporal lobe resection, removal of tumors, and removing parts of the neocortex. Some procedures such as a corpus callosotomy are attempted in an effort to decrease the number of seizures rather than cure the condition. Following surgery, medications may be slowly withdrawn in many cases. Neurostimulation
Neurostimulation via neuro-cybernetic prosthesis implantation, may be another option in those who are not candidates for surgery, providing chronic, pulsatile electrical stimulation of specific nerve or brain regions, alongside standard care.