Health condition · Clinically reviewed
Epilepsy, types of seizures, medications and living well.
A tendency to recurrent unprovoked seizures. Modern anti-seizure medication controls seizures in most patients — with clear driving rules, safety planning and support around it.
Why trust this guide
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Clinically reviewed
Written by our editorial team and reviewed by a registered UK clinician before publication.
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Sourced from guidance
Every claim is checked against NICE, ILAE or peer-reviewed sources you can see at the end.
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Updated for 2026
Reflects current UK guidance including NICE NG217 and MHRA valproate advice.
Key facts
Epilepsy at a glance.
The essentials, in plain English — what it is, how it is classified, how common it is, and how it is treated in the UK today.
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Definition
A tendency to recurrent unprovoked seizures — usually two or more, or one with a high risk of recurrence.
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Classification
Seizures are grouped as focal (starting in one area) or generalised (both hemispheres from the start).
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How common
Around 1 in 100 people in the UK live with epilepsy — roughly 600,000 people.
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Medication
First-line anti-seizure medication depends on seizure type — the wrong drug can make some seizures worse.
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SUDEP
Sudden unexpected death in epilepsy is a rare but real risk — most reduced by good seizure control.
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Driving
DVLA rules apply — a car licence requires being seizure-free for at least 1 year (longer for a bus or lorry).
Why this guide matters
The right drug for the right seizure.
Modern anti-seizure medication controls seizures in most people — but only when the seizure type is classified correctly. Three points that shape everything else.
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Classification comes first
Focal vs generalised, and the specific subtype, decides which drug will help — and which could make things worse.
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Adherence beats dose
A missed dose is the single most common reason previously well-controlled seizures return.
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DVLA and pregnancy plans
Driving rules and pregnancy planning need active conversation early — not after a seizure or a positive test.
How the diagnosis is made
From first event to a clear plan.
The steps a UK GP and neurology team will normally follow, in order — so you know what to expect and why.
Phase 1 · History
Eyewitness account, examination and bedside tests
Phase 2 · Investigations
ECG, EEG and MRI to classify and find a cause
Phase 3 · Plan
Neurology confirms and starts treatment
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History
An eyewitness account
A description — ideally a phone video — from someone who saw the event is the single most useful piece of information.
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History
Neurological exam
A focused examination of eye movements, strength, coordination and reflexes to look for a structural cause.
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History
Blood tests
Glucose, sodium, calcium, kidney and liver function — to exclude a metabolic trigger.
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Investigations
ECG
A 12-lead ECG rules out a cardiac rhythm cause, especially long QT — which can look identical to a seizure.
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Investigations
EEG
Records brain electrical activity. A video-EEG over hours or days is arranged when the diagnosis is uncertain.
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Investigations
MRI brain
Looks for a structural cause — scar, tumour, hippocampal sclerosis or cortical malformation.
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Plan
Neurology consultation
A neurologist confirms the diagnosis, classifies the seizure type and starts the right anti-seizure medication.
Typical timeline: 4-12 weeks from first event to a settled plan.
Seizure types
What different seizures actually look like.
Seizures come in many forms — from a full convulsion to a brief blank stare. Recognising the pattern is the first step to the right treatment.
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Generalised tonic-clonic
Sudden stiffening then rhythmic jerking of all limbs, loss of consciousness, often tongue biting or incontinence.
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Focal seizure
Starts in one area — twitching, odd smell or taste, déjà vu, or a strange rising feeling — awareness may be kept or lost.
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Absence seizure
Brief blank staring spells lasting seconds, most common in children — often mistaken for daydreaming.
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Tonic seizure
Sudden stiffening of the body without the jerking phase — often causes a fall.
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Myoclonic jerks
Sudden brief muscle jerks, often in the arms shortly after waking — common in juvenile myoclonic epilepsy.
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Atonic (drop) seizure
A sudden loss of muscle tone causing a fall — often requires a protective helmet.
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Status epilepticus
A seizure lasting more than 5 minutes, or repeated seizures without recovery in between — a medical emergency.
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Red flag: prolonged seizure
A seizure lasting over 5 minutes, or repeated seizures without recovery — call 999 immediately.
Treatment
How epilepsy is treated in the UK.
First-line medications, add-on options and non-drug therapies — what each one does, and where it fits in NICE NG217.
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Sodium valproate
Highly effective for generalised epilepsies — but MHRA restricts use in women of childbearing potential due to serious risk in pregnancy.
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Lamotrigine
A broad-spectrum first-line option, especially in women of childbearing age — introduced slowly to reduce rash risk.
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Levetiracetam
A common first-line drug — few interactions and fast titration. Mood side effects can occur.
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Carbamazepine
A long-standing first-line option for focal seizures — can worsen some generalised seizures, so classification matters.
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Perampanel
An adjunctive option for focal and generalised tonic-clonic seizures when first-line drugs are not enough.
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Cenobamate
A newer add-on for treatment-resistant focal seizures — recommended by NICE with careful titration.
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Vagus nerve stimulation (VNS)
An implanted device delivering pulses to the vagus nerve — an option when medications and surgery are not suitable.
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Ketogenic diet
A specialist high-fat, low-carbohydrate diet — used mainly in paediatric epilepsy that has not responded to medication.
What this guide is based on
The sources behind every claim on this page.
UK national guidance and specialist society standards, current at the time of last review.
Key references
Guidelines and standards we relied on.
A quiet reminder
This guide is for information, not medical advice.
Your GP or neurologist knows your history and can tell you which parts apply to you. If in doubt, seek assessment — especially with any red-flag features.
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NICE. Epilepsies in children, young people and adults (NG217).
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Epilepsy Action. Information and support for people with epilepsy.
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International League Against Epilepsy (ILAE). Classification of seizures and epilepsies.
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DVLA. Assessing fitness to drive — a guide for medical professionals.
Red flags
When a seizure needs urgent care.
Most seizures self-terminate within a couple of minutes. These are the patterns and situations that need immediate assessment.
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Status epilepticus
Any seizure lasting more than 5 minutes, or repeated seizures without recovery — call 999.
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First seizure ever
A first unprovoked seizure needs urgent (within 2 weeks) neurology assessment — not driving until reviewed.
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Post-partum seizure
A new seizure after childbirth needs immediate assessment — eclampsia must be excluded.
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Head injury after seizure
A fall during a seizure with head impact needs urgent review — especially if on anticoagulants.
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Aspiration during seizure
Vomiting or choking with breathlessness or fever afterwards — seek same-day assessment.
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SUDEP counselling
Sudden unexpected death in epilepsy is rare but real — good seizure control is the best protection.
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Pregnancy planning
Discuss medication before conception — some drugs (especially valproate) carry serious risks to the baby.
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Any medication change in pregnancy
Never stop or change anti-seizure medication in pregnancy without specialist advice — uncontrolled seizures also carry risk.
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Sudden loss of seizure control
A run of seizures on previously stable medication — check adherence, sleep, alcohol and interactions urgently.
Living with it
A long-term condition, but a very manageable one.
Four habits make the biggest difference day to day — sleep, adherence, DVLA compliance and a quiet safety plan at home.
A quiet reminder
Consistency beats intensity, every time.
Small, steady changes — kept up for months — do more than a heroic week that does not last.
- 01 Rhythm
Sleep is a seizure trigger
Regular sleep, avoiding late nights and shift work where possible, reduces breakthrough seizures more than most people expect.
- 02 Adherence
Take it, every day, at the same time
Missed doses are the single most common cause of a seizure in someone previously well controlled — set alarms and use a pill box.
- 03 Driving
DVLA rules exist for a reason
You must tell the DVLA about any seizure — a car licence requires being seizure-free for 1 year, and a bus or lorry licence 10 years.
- 04 Safety
A quiet safety plan at home
Showers rather than baths, cooking on back rings, and telling a trusted person where you are — small habits that add up.
Frequently asked
Everything we get asked about epilepsy.
Quick answers on classification, medication, driving, SUDEP, first aid and pregnancy.
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What actually is epilepsy?
A tendency to have recurrent unprovoked seizures — usually defined as two or more seizures more than 24 hours apart, or one seizure with a high risk of another. A single provoked seizure (for example after low blood sugar or a head injury) is not epilepsy on its own.
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What is the difference between focal and generalised seizures?
Focal seizures start in one part of the brain and may or may not affect awareness. Generalised seizures involve both sides of the brain from the start — including tonic-clonic, absence, myoclonic, tonic and atonic types. Getting the classification right is what guides medication choice.
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Which anti-seizure medication is best?
It depends on the seizure type. Lamotrigine and levetiracetam are common first-line choices in adults. Sodium valproate is highly effective but avoided in women of childbearing potential because of pregnancy risks. Carbamazepine remains first-line for focal seizures but can worsen some generalised types.
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Can I drive if I have epilepsy?
You must tell the DVLA. For a car (Group 1) licence you generally need to be seizure-free for 1 year — with some exceptions for seizures only during sleep. A bus or lorry (Group 2) licence requires 10 years seizure-free and off medication. Not telling the DVLA is a criminal offence.
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What is SUDEP and how do I lower the risk?
SUDEP — sudden unexpected death in epilepsy — is rare but real. The most important protection is good seizure control: taking medication reliably, sleeping enough, limiting alcohol and keeping regular neurology review. Nocturnal monitors are an option for some.
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What should someone do when they see a seizure?
Stay calm, time it, protect the head with something soft, move dangerous objects away, and put the person in the recovery position once jerking stops. Do not put anything in the mouth. Call 999 if the seizure lasts more than 5 minutes, they don’t recover, or another seizure starts.
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