Epilepsy
Epilepsy is a neurological disorder that causes seizures or episodes of unusual behavior, sensations and sometimes loss of awareness. It is caused by abnormal brain activity.
What’s in this section?
Signs and Symptoms
Symptoms of epilepsy depend on the seizure type. The most common symptoms include:
- Temporary confusion
- Staring for a period of time
- Jerking movements of the arms and legs that cannot be controlled
- Loss of awareness or consciousness
- Fear or anxiety
- Déjà vu
Potential Causes
Common causes of epilepsy include problems with normal brain development/wiring, brain inflammation, physical injury or infection.
Diagnosis
Diagnosis starts with a physical exam and medical history. Other procedures and tests may be needed to diagnose, including: a detailed neurological exam , electroencephalogram ( EEG ), blood tests, computed tomography ( CT ) or magnetic resonance imaging ( MRI ).
Treatment Options
There are different treatment options depending on the severity of your epilepsy:
- Anti-seizure medication
- Epilepsy surgery You may need this surgery if you have medically refractory epilepsy (uncontrolled seizures). Patients who are still having breakthrough seizures despite being on multiple medications are considered for surgery to improve their quality of life.
- Formal brain surgery The source of the seizures is removed through open craniotomy surgery, which may lead to a permanent cure. Formal brain surgery is similar to brain tumor surgery. Sometimes patients have a diagnostic surgery where either electrodes in the form of grids, strips or leads are placed in the operating room, and patients are monitored for approximately one week to help localize the exact areas of damaged brain that need to be removed to prevent seizures. If you need a diagnostic surgery, you will stay in the hospital between the two operations. You will be completely asleep for both operations.
- Lesioning procedures Small locations of the brain are burned to stimulate surgical removal, but will not likely lead to a permanent cure. Lesioning procedures require you to have a stereotactic frame placed on your head and a special MRI done prior to going to the operating room. You will be asked to perform certain tasks in the operating room to increase the safety of the operation. You will typically stay one to two nights after surgery.
- Stimulation Specific locations in the brain are stimulated to decrease and manage the seizures, but not likely to permanently cure them. For stimulation surgeries, you will be completely asleep for any of the procedures. For the vagal nerve stimulator (VNS), you will go home the same day of the procedure. VNS surgery is performed on two locations: the neck and the chest. For the deep brain stimulation (DBS), you will typically stay one to two nights after surgery. DBS surgery is performed on two locations: the brain and the chest. In both surgeries, a battery (generator) is placed, similar to a pacemaker.
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