Duke neurologist Rodney Radtke, MD, says one of the greatest challenges in treating epilepsy is countering assumptions -- those of patients and of society. “There are too many patients who’ve had epilepsy for 20 years and who think they’re doing well when they have only three seizures a month.”

For people with active seizures, epilepsy -- and the social stigma that surrounds it -- can be a life-limiting illness. It affects one’s ability to get driver’s license or long-term employment, and it can be very socially isolating, says Radtke. “If you have a seizure on your first date,” he says, "very often there isn’t going to be a second date.”

Many people believe there’s little they can do to change either the stigma or the seizures. This is because between 1978 and 1993 there were no new medicines for the treatment of epilepsy, says Radtke. “So if a patient was diagnosed during that time, he could try the three or four drugs that were available. If they didn’t work well for him, he just had to live with it.”

But since 1993, 10 new medications have come on the market, and more are on the way. Researchers at Duke and elsewhere are also using advances in genetic technology to better understand the genetics of the disease -- both what makes some people more susceptible to epilepsy than others, and why some treatments work more effectively -- and are better tolerated -- by certain patients, while other patients respond best to different medications. Radtke says that physicians have also become adept at identifying whether a patient might benefit from surgery to remove scars and structural abnormalities.

“If a patient has active seizures, or if his medication is causing side effects that limit his quality of life, we want that patient to talk to his physician about new strategies to try," says Radtke.