Frequently Asked Questions

Reference:  Epilepsy Foundation (visit epilepsyfoundation.org for more information)

WHAT IS EPILEPSY?

Epilepsy is a nervous system disorder that disrupts normal electrical activity in the brain.  It affects 2.2 million Americans and 65 million people worldwide.  Epilepsy is the fourth most common neurological disorder in the U.S. after migraine, stroke, and Alzheimer's disease. Its prevalence is greater than autism spectrum disorder, cerebral palsy, multiple sclerosis and Parkinson's disease combined. Despite how common it is and major advances in diagnosis and treatment, epilepsy is among the least understood of major chronic medical conditions, even though one in three adults knows someone with the disorder.

WHAT CAUSES EPILEPSY?

Seizures are symptoms of abnormal brain function. With the exception of very young children and the elderly, the cause of the abnormal brain function is usually not identifiable.

Symptomatic seizures are called that when they can be linked to identifiable diseases or brain abnormalities.

Cryptogenic seizures are diagnosed when no cause for the seizures can be found. Idiopathic or primary seizures are diagnosed when a genetic (or family) cause for the seizures is suspected

Some potential causes include, but are not limited to:  brain malformations, brain tumors, infection, head trauma and genetic factors.

TYPES OF SEIZURES:

There are many different types of seizures. People may experience just one type or more than one. The kind of seizure a person has depends on which part and how much of the brain is affected by the electrical disturbance that produces seizures.  Experts divide seizures into generalized seizures (absence, atonic, tonic-clonic, myoclonic), partial (simple and complex) seizures, gelastic seizures, dacrystic seizures, non-epileptic seizures and status epilepticus.

DIAGNOSIS:

Diagnosing epilepsy is a multi-step process.

The first step in diagnosing epilepsy is a careful medical history with as much information as possible about what the seizures looked like and what happened just before they began.   The doctor will then do a thorough physical examination, especially of the nervous system, as well as analysis of blood and other bodily fluids.

Electroencephalographic Investigation (EEG):  EEG remains the most important test for studying electrical brain activity.  It is used in evaluating patients' suspected seizures by helping to determine precisely the patient's seizure type, and as part of testing for individuals undergoing pre-surgical evaluation.     

Imaging methods such as CT (computerized tomography) or MRI (magnetic resonance imaging) scans may be used to search for any growths, scars or other physical conditions in the brain that may be causing the seizures.

If the CT/MRI and EEG all come back as normal, Ambulatory EEG monitoring can then help with diagnosis.  Through the use of ambulatory EEG recording, patients can undergo continuous EEG recording while at home.  This technique is useful in helping diagnose seizures while allowing patients to continue their everyday activities.

If no events are captured and results are normal for ambulatory EEG monitoring, in-patient monitoring is recommended.  Through admittance to a local hospital, inpatient video monitoring further enables the doctor to diagnose difficult cases, determine optimal medication regimens, and evaluate epilepsy surgery patients.

TREATMENT:

There is no cure for epilepsy, yet. Medications do not cure epilepsy in the same sense that 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 may take some time to find exactly the right dose of the right drug for each person with epilepsy.

Approved medications for Epilepsy: » Ativan® » Banzel» Carbatrol» Depakene» Depakote» Depakote ER» Diamox® Sequels®» Diastat Acudial» Dilantin» Felbatol» Gabitril» HP Acthar Gel» Keppra» Keppra XR » Klonopin» Lamictal» Lyrica» Mysoline» Neurontin» Onfi» Phenobarbital» Phenytek» Potiga» Sabril (for children)» Sabril (for adults)» Tegretol» Tegretol XR» Topamax» Tranxene» Trileptal» Vimpat» Zarontin» Zonegran

Brain surgery can be a successful way of treating epilepsy if you are a qualifying candidate. Surgery for epilepsy is a delicate, complicated operation. It must be performed by a skilled, experienced surgical team.  Afterwards, some seizure medications may have to be continued, usually for a year or two. Then, if no further seizures occur, the medicine may be slowly withdrawn. At this point, chances of living free of seizures and free of medication are good. However, many people will have to continue with medication and some do not benefit from surgery.

Vagus nerve stimulation (VNS) is a type of treatment in which short bursts of electrical energy are directed into the brain via the vagus nerve, a large nerve in the neck. The energy comes from a battery, about the size of a silver dollar, which is surgically implanted under the skin, usually on the chest. Just how it works to prevent seizures is being studied.

Clinical Trials are another good option for some patients.  You can visit www.clinicaltrialsinc.com to view all of our ongoing studies.  For a list of all clinical trials, go to www.clinicaltrials.gov.

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