Epilepsy is a condition of the brain that causes repeated seizures. A seizure is a sudden burst of abnormal electrical activity in the brain. It can cause jerking, stiffness, a blank stare, odd sensations or a brief loss of awareness. The HSE says it is usually lifelong, but that the right treatment can prevent seizures for many people.
Over 45,000 people in Ireland have epilepsy, according to Epilepsy Ireland. Diagnosis is made by a specialist, usually after a GP or emergency department referral. Medicines are the main treatment. Epilepsy Ireland says up to 70% of people can become seizure-free once the right treatment is found. For the rest, surgery, a vagus nerve stimulator, a specialist diet or, for some rare childhood-onset epilepsies, cannabidiol may be options.
Sometimes no cause is found. Genes play a part, and some people have a relative with epilepsy. The HSE lists damage to the brain as another cause, for example from:
Epilepsy can start at any age. The HSE notes it most often begins in young children and people over 50.
Seizures are grouped by where they start in the brain. Focal seizures start in one area. Generalised seizures involve both sides of the brain from the start. You can have more than one type.
Source: HSE, diagnosis of epilepsy.
Focal seizures are often missed. Epilepsy Action says about 6 in 10 people with epilepsy have them. They can cause déjà vu, a rising feeling in the stomach, an odd smell, lip smacking or fidgeting. A focal seizure can spread and become a tonic-clonic seizure. A warning "aura" is itself a focal seizure. Seizure names were updated in 2025, so clinic letters may use older or newer terms.
One seizure does not always mean epilepsy. The HSE says a doctor may diagnose it if you have had more than one seizure, or have a risk of more.
In England, NICE guideline NG217 says anyone with a first suspected seizure should be referred urgently, for an appointment within 2 weeks. For adults, this should be to a clinician with expertise in first seizures.
An account of what happened matters most. The HSE suggests bringing someone who saw the seizure to your appointment. Tests you might have include:
A normal EEG does not rule epilepsy out. NICE is clear that EEG should not be used to exclude a diagnosis.
In Ireland, your GP refers you to a consultant neurologist or epileptologist (an epilepsy specialist). Epilepsy Ireland says services under the HSE National Clinical Programme for Epilepsy are in public hospitals in Dublin, Cork, Galway, Sligo and Limerick, with more in Waterford and Kerry. Our guide to getting referred to a neurologist in Ireland explains the routes.
Anti-seizure medicines are the main treatment. They do not cure epilepsy; they aim to stop seizures. The choice depends on seizure type, age, sex, other conditions and whether you could become pregnant.
NICE sets out first choices by seizure type. Irish neurologists are not bound by NICE, but the medicines are the same.
Source: NICE NG217, section 5. Valproate is always subject to the safety rules below.
If the first medicine does not work, another is tried, then add-on treatments. Epilepsy Ireland says that for up to 30% of people, seizures stay hard to control despite treatment.
Some practical points from the HSE and NHS:
Other medicines and remedies can interfere with anti-seizure medicines. St John's wort, for example, can lower the blood levels of some of them. We explain this in St John's wort and epilepsy medication. Ask your pharmacist before taking anything new.
Sodium valproate (Epilim and other brands) works well for some generalised epilepsies but carries serious risks in pregnancy. The UK regulator, the MHRA, says that when valproate is taken in pregnancy:
In Ireland, the HPRA requires valproate to be used under the PREVENT pregnancy prevention programme for women and girls who could become pregnant. In the UK, valproate must not be prescribed to them unless the Pregnancy Prevention Programme is followed. The MHRA also says that anyone under 55 starting valproate needs two specialists to agree that other treatments are unsuitable.
There is also precautionary advice for men. A study reviewed by the HPRA in April 2024 looked at children whose fathers took valproate in the 3 months before conception. The adjusted risk of neurodevelopmental disorders was 4.0% to 5.6%. That compared with 2.3% to 3.2% when fathers took lamotrigine or levetiracetam. The HPRA says a causal link is not confirmed. Men are advised to consider effective contraception, including for a partner, and to discuss options if planning a family.
The message from both regulators is the same: do not stop valproate on your own. Talk to your specialist first, and urgently if you are pregnant or planning a pregnancy.
NICE defines drug-resistant epilepsy as seizures continuing after two suitable, well-tolerated medicines have been tried properly. At that point, other treatments come into play.
Epilepsy surgery. Surgery removes or disconnects the small area of brain where seizures start. NICE says everyone with drug-resistant epilepsy should be referred to a specialist centre to consider surgery, including people whose MRI looks normal. It found resective surgery is the most effective treatment for drug-resistant focal epilepsy. NICE also says people with learning disabilities or genetic conditions should not be excluded from referral.
In Ireland, the national epilepsy surgery programme is at Beaumont Hospital, Dublin. Assessment is lengthy, with video EEG, specialised scans and neuropsychology tests. Epilepsy Ireland says up to 70% of people who have temporal lobe surgery are seizure-free two years later. Results depend on the type of surgery and the person.
Vagus nerve stimulation (VNS). A small battery-powered device is placed under the skin on the left side of the chest. A wire connects it to the vagus nerve in the neck. It sends regular mild pulses that, in some people, reduce how often and how hard seizures happen. It is used alongside medicine.
NICE says to consider VNS when surgery is not suitable. It also notes there is no long-term robust evidence on VNS, that it does not work for everyone, and that it is not risk-free. Epilepsy Ireland says benefit may take up to a year. Hoarseness and coughing during stimulation are common side effects.
Ketogenic diet. The ketogenic diet is very high in fat and very low in carbohydrate. NICE says to consider it only under a specialist epilepsy team, mainly for certain childhood epilepsy syndromes or drug-resistant epilepsy where other options have failed. It is a medical treatment, not a lifestyle diet. We cover the trial evidence and its side effects in epilepsy: diet works, antioxidants don't.
Cannabidiol (Epidyolex). Epidyolex is a licensed, highly purified cannabidiol (CBD) medicine. In Ireland, the UK and the EU it is authorised only for seizures in three rare conditions, in people aged 2 and over:
The European Medicines Agency says five studies in over 900 patients showed it reduced seizures when added to other medicines. It can affect the liver, so blood tests are needed. The UK product information notes that benefit has not been established in people with Lennox–Gastaut or Dravet syndrome who are not taking clobazam.
CBD oils sold in shops are not the same product. The NHS warns their quality and content are unknown, and some may contain THC and be illegal.
Checked 3 November 2026.
Sources: NCPE, NICE TA614, TA615, TA873, gov.ie.
The products in Ireland's Medical Cannabis Access Programme are not authorised medicines. Epilepsy Ireland reports that none of the listed products met the Department of Health's own clinical guidance for use in epilepsy, which calls for a high-CBD product with only trace THC.
Clinical trials. On 3 November 2026, ClinicalTrials.gov listed no epilepsy trials as recruiting at sites in Ireland, and 18 recruiting at UK sites. Trials are research, not a treatment route.
The HSE recommends some practical steps:
SUDEP. Sudden unexpected death in epilepsy is rare. Epilepsy Action puts it at around 1 in 1,000 people with epilepsy each year. Uncontrolled tonic-clonic seizures raise the risk. NICE says clinicians should discuss it, especially with people who have seizures in their sleep. Taking medicines as prescribed is one of the main ways to lower it.
Driving. You must stop driving after a seizure and tell the licensing authority. In Ireland, you need at least a year free of seizures while awake before driving again, with some exceptions. Our guide to driving with a neurological condition in Ireland covers the rules.
Support. Epilepsy Ireland: 01 455 7500. Epilepsy Action (UK): 0808 800 5050. If your mood is low or you are struggling, talk to your GP. In a crisis, call Samaritans on 116 123 (Ireland and UK), text 50808 (Ireland), or call 112 or 999.
Can epilepsy go away? Sometimes. The HSE says some people can stop treatment if their seizures stop over time. That decision should be made with your specialist, because stopping can bring seizures back.
Does a normal EEG mean I don't have epilepsy? No. Many people with epilepsy have a normal EEG between seizures. NICE says EEG should not be used to rule epilepsy out. Diagnosis rests mainly on a detailed account of what happened.
Can I buy CBD oil for epilepsy? The licensed CBD medicine, Epidyolex, is only for three rare conditions and needs a specialist. Shop-bought CBD is a different product of unknown content, and some contains THC. Talk to your neurologist first.
This article is general information, not medical advice. Do not start, stop or change any epilepsy treatment without talking to your GP, specialist or pharmacist.
Reviewed by: Proco Team
Last updated: November 2026