Most adults with epilepsy are treated with anti-seizure medication, and the majority achieve good control on the first or second drug tried. When seizures continue despite two appropriate medications, the next steps include reassessing the diagnosis, considering surgical evaluation, devices, or dietary therapy.
Most adults with epilepsy are treated with anti-seizure medication, and the majority achieve good control on the first or second drug tried. When seizures continue despite two appropriate medications, the next steps include reassessing the diagnosis, considering surgical evaluation, devices, or dietary therapy.
The choice of anti-seizure medication depends on the seizure type, other medical conditions, other drugs you take, and whether pregnancy is a consideration. The aim is no seizures with side effects you can live with, and both halves of that sentence matter: a drug that stops seizures but leaves you unable to work is not a success. Dose adjustment over several visits is normal rather than a sign of failure.
If two appropriately chosen and adequately dosed medications have not controlled seizures, the situation is described as drug-resistant, and simply adding a third drug has a lower chance of success. At that stage the first move is often to revisit the diagnosis, because some episodes that look like epilepsy are not, and prolonged EEG recording is how that is checked.
Options for drug-resistant epilepsy include evaluation for surgery when seizures come from one identifiable area, implanted stimulation devices, and dietary approaches. These are assessed at specialised epilepsy centres. CNS performs no surgery, so the role here is diagnosis, medical management, monitoring, and referral when a surgical evaluation is the right next step.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: epilepsy; American Academy of Neurology; National Institute of Neurological Disorders and Stroke.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.