Background on Epilepsy
MRI showing hippocampal sclerosis (also called mesial temporal sclerosis), one of the most common findings in temporal lobe epilepsy. Patients with hippocampal sclerosis may be good candidates for surgery to treat their epilepsy if the seizures come exclusively from the bright area seen in the scan. Our video-EEG procedures are designed to verify when that is the case. Read more about video-EEG and our Epilepsy Monitoring Unit.
More than 2.5 million people in the U.S. and 40 million worldwide have some form of epilepsy. The condition is characterized by seizures, which are disturbances in the electrical activity of the brain. According to the Epilepsy Foundation, there are over 50,000 people living with epilepsy in San Diego County.
Epilepsy can begin at any age. Sometimes the onset of seizures is attributed to injury, infection or hereditary predisposition, but often, there is no known cause or trigger for epilepsy. Undiagnosed and uncontrolled, it may progressively alter normal brain function and create serious social and psychological problems. For these reasons, early diagnosis and treatment are crucial.
Advanced Technology Improves Evaluation and Diagnosis
There are different types of seizures. Non-epileptic spells, which typically don’t respond to anti-epileptic medications, may be difficult to distinguish from epileptic events. An accurate diagnosis of seizure type is critical in determining the optimal epilepsy treatment. Properly diagnosed, epilepsy can often be controlled with medication.
There are different types of seizures. An accurate diagnosis of seizure type is critical in determining the optimal treatment.
The Epilepsy Center uses leading-edge technology and advanced evaluation procedures to properly diagnose people experiencing any kind of seizure or abnormal electrical activity in the brain. These tools include:
- Video-EEG monitoring
- Magnetic resonance imaging (MRI)
- Neuropsychological evaluation
- Functional neuroimaging
- Language and memory lateralization (Wada) test
There are more than 20 prescription seizure medications. These medications control seizures in approximately 70 percent of patients. Medication for seizures is not a cure for epilepsy. Single drugs or combinations of medications are prescribed to best control or limit seizures with the least amount of side effects.
If medications are not efficient, the team at the Epilepsy Center works with families and individuals to help them understand other therapy options, including a special diet or surgery.
Read more about medications for epilepsy at Epilepsy Foundation.
The Epilepsy Center at UC San Diego Health System provides nutritional guidance and monitoring to patients who manage epileptic seizures with a ketogenic diet. Ketones are produced when the body metabolizes fat. When ketones are present in the body, seizures are often reduced or eliminated. By consuming primarily fats and protein and very few carbohydrates, the body relies on burning fat for energy, causing ketones to build up in the blood, reducing epileptic seizure occurrences. The ketogenic diet is challenging to adhere to, but has been shown to be highly effective for some patients.
Surgical interventions for epilepsy can provide many patients a life free of seizures. If medications and dietary changesare not working to control seizures, the Epilepsy Center team, including neurologists, electrophysiologists, cognitive specialists and neurosurgeons, determine whether epilepsy surgery is an option. Epilepsy that causes seizures that are resistant to medication is called intractable epilepsy. MRI brain imaging, EEG and functional neuroimaging are used to pinpoint where the electrical abnormality is occurring in the brain. If a person’s seizures begin in a single focus, they may benefit from surgical treatment to remove the epileptogenic tissue.
Vagus Nerve Stimulation
If the seizure focus is not well localized, patients may be candidates for vagus nerve stimulation (VNS). The vagus nerve is one of twelve paired cranial nerves that carries information to and from many parts of the brain. The nerve can be easily accessed and stimulated at low levels of electrical current that are barely felt by the patient. Stimulation of the vagus nerve by electric impulses at regular intervals has shown to significantly decrease seizures in patients with epilepsy that is not responding sufficiently to medication. Vagus nerve stimulation is a surgical procedure performed under general anesthesia.