Determining the best treatments for epilepsy depends on obtaining an accurate diagnosis. Once epilepsy is confirmed, any underlying causes identified and the type determined when possible, doctors can respond with an array of therapies including medications and surgical intervention. Specialists in different areas of medicine provide treatments for epilepsy. In addition to the primary care physician, a neurologist or epileptologists (a subspecialty focused on epilepsy) confirms the diagnosis and consults on care. The patient may also be referred to a neurosurgeon for treatment. For about two thirds of people with epilepsy the most effective treatment options are antiepileptic medications that may be used singly or in combination. Depending on how the patient responds, the doctor may adjust dosage or change drugs. More than 20 types of antiepileptic medications are now available including ethosuximide, clonazepam, phenobarbital, and primidone. Some of these drugs cause fatigue, weight gain, dizziness and other side effects and suddenly discontinuing drug therapies can trigger sudden, severe seizures. When seizures always begin in one area of the brain, and medication alone does not control seizures, surgery may be considered as a treatment for epilepsy. Location is critical as doctors prefer not perform surgery in areas of the brain … Continue reading →

What Is It? A seizure is a sudden change in the brain's normal electrical activity. During a seizure, brain cells "fire" uncontrollably at up to four times their normal rate, temporarily affecting the way a person behaves, moves, thinks or feels. There are two major types of seizures: Primary generalized seizures The seizure affects the entire cerebral cortex, the outer portion of the brain that contains the majority of brain cells. In this type of seizure, the abnormal firing of brain cells occurs on both sides of the brain at about the same time. Partial (focal) seizure The abnormal firing of brain cells begins in one region of the brain and remains in that one region. Many conditions can affect the brain and trigger a seizure, including: Brain injury, either before or after birth Infections, especially meningitis and encephalitis Eating or drinking toxic substances Metabolic problems High fever (in children) Genetic conditions, including tuberous sclerosis Structural abnormalities in the brain's blood vessels Seizures are common. A person may have only one seizure without a recurrence. Epilepsy is a condition in which seizures continue to recur. Primary Generalized Seizures The different types of primary generalized seizures cause different symptoms: Generalized tonic-clonic … Continue reading →

Key facts Epilepsy is a chronic disorder of the brain that affects people worldwide. It is characterized by recurrent seizures, which are brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body (generalized), and are sometimes accompanied by loss of consciousness and control of bowel or bladder function. Seizure episodes are a result of excessive electrical discharges in a group of brain cells. Different parts of the brain can be the site of such discharges. Seizures can vary from the briefest lapses of attention or muscle jerks to severe and prolonged convulsions. Seizures can also vary in frequency, from less than 1 per year to several per day. One seizure does not signify epilepsy (up to 10% of people worldwide have one seizure during their lifetime). Epilepsy is defined as having 2 or more unprovoked seizures. Epilepsy is one of the worlds oldest recognized conditions, with written records dating back to 4000 BC. Fear, misunderstanding, discrimination and social stigma have surrounded epilepsy for centuries. This stigma continues in many countries today and can impact on the quality of life for people with the disorder and their families. Characteristics of seizures vary and … Continue reading →

Your treatment plan will depend upon a number of factors, including: Because each persons treatment is unique and individualized, we cannot provide a one-size-fits-all description of treatment. But there are some general options for treating epilepsy. Your treatment plan will include one of or a combination of these options: Not all people with seizures will require treatment. If youve only had one seizure, or your seizures dont put you in danger, we may take a watch and wait approach rather than starting medication right away. Back to top If we agree that a medical approach to treatment is best for you, we will start with medication. The medication we use falls into a class of drugs called anti-epileptic drugs (AEDs). Significant progress has been made in medical management of epilepsy in the last several decades. The number of available AEDs has increased from a handful in the early 1980s to more than 20 today. The new generation of AEDs is not necessarily more effective than the old medications, but they are a lot more tolerable in terms of side effects. With new choices, patients have more opportunities to find the right medication that provides satisfying seizure control and minimizes the … Continue reading →

There is no cure for epilepsy, yet. Medications do not cure epilepsy in the same waythat penicillin can cure an infection. For many people with epilepsy, however, the medication will prevent seizures as long as they are taken regularly; but, successful drug therapy requires the active cooperation of the patient. Antiepileptic drugs successfully prevent seizures in the majority of people who take them regularly and as prescribed. It has been estimated that at least fifty percent of all patients with epilepsy gain complete control of their seizures for substantial periods of time. Another twenty percent enjoy a significant reduction in the number of seizures. If patients, in collaboration with their physicians, decide to attempt withdrawal from medications, they should be aware that the seizures may recur and should closely observe seizure precautions. Some individuals, however, have an excellent chance of remaining seizure free without medication in the future. When the doctor has made a diagnosis of seizures or epilepsy, the next step is to select the best form of treatment. If the seizure was caused by an underlying correctable brain condition, surgery may stop seizures. If epilepsy that is, a continuing tendency to have seizures is diagnosed, the doctor will … Continue reading →

SURGICAL TREATMENT OF EPILEPSY by: G. Rees Cosgrove, M.D., F.R.C.S.(C) and Andrew J. Cole M.D., FRCP(C) Departments of Neurology and Neurosurgery, Massachusetts General Hospital Epilepsy Center, Harvard Medical School, Boston, Massachusetts Address correspondence to: Emad N. Eskandar, M.D. E-mail: eeskandar@partners.org Patient Appointments: 617.724.6590 FAX: 617.724.0339 Referrals | Stereotactic Surgery | Parkinson's Disease | Intractable Epilepsy | Movement Disorder Surgery Guestbook | Selected Publications | Links INTRODUCTION In the majority of patients with epilepsy, seizures can be well controlled with appropriate medication. However, current estimates indicate that 20 - 30% of patients with epilepsy are refractory to all forms of medical therapy.(1) These medically intractable patients are candidates for surgical treatment in an attempt to achieve better seizure control. Another group of patients who might benefit are those whose seizures may be relatively well controlled but who have certain characteristic presentations or lesions that strongly suggest surgical intervention might be curative. Overall, the single most important determinant of a successful surgical outcome is patient selection. This requires detailed presurgical evaluation to characterize seizure type, frequency, site of onset, psychosocial functioning and degree of disability in order to select the most appropriate treatment from a variety of surgical options. This type of … Continue reading →

Home neurosciencesNeurology Neurology Specialties Epilepsy Services & Treatments The Emory Epilepsy Center offers comprehensive services, including those for diagnosis, treatment, and rehabilitation. Some patients may not find relief from seizure medication because they have been misdiagnosed. In fact, they do not have seizures, but another medical or psychiatric issue. In order to more accurately diagnose epilepsy and seizures, the Emory Epilepsy Center utilizes our Epilepsy Monitoring Unit (EMU), a 10-bed inpatient unit in the main hospital. Patients are admitted for continuous video-EEG monitoring; EEG data is recorded 24 hours a day, along with time-locked video. Antiseizure medications are reduced, allowing for the capture and characterization of the patients typical spells. Often times, patients have been misdiagnosed with seizures, and as a result of video EEG monitoring, antiseizure medications can be discontinued. Additionally, accurate diagnosis can lead to selection of the most effective medication for the captured seizure type. Video EEG monitoring can also be performed as part of the presurgical workup in patients with epilepsy whose seizures do not respond to antiepileptic medication. With video EEG, epilepsy doctors aim to find the area of the brain where seizures are starting. This helps determine whether surgery is a treatment option. Anti-epileptic … Continue reading →