Epilepsy Treatments
The Emory Epilepsy Center offers comprehensive services, including those for diagnosis, treatment, and rehabilitation.
Diagnostic Services
The Emory Epilepsy Center uses the latest diagnostic tools to identify the causes of epilepsy. These tools include:
- Electroencephalography (EEG) to measure brain electrical activity. EEG is conducted to interpret the electrical brain activity and to determine focal (localized) or generalized (diffuse) abnormalities of the brain's firing pattern. EEG can be performed with video or as a prolonged ambulatory recording.
- Structural neuroimaging, a major diagnostic service of the Emory Epilepsy Center and Emory Department of Radiology, to detect lesions and biochemical dysfunction that cause epilepsy.
- Functional neuroimaging, with positron emission tomography (PET) or single photon emission computed tomography (SPECT) scans, to map the patterns of blood flow, energy use, and membrane receptors in specific brain regions.
- Neuropsychological testing to measure the severity of memory and other cognitive dysfunction that can occur in many individuals with epilepsy.
- Genetic testing, blood chemistry, and other laboratory tests also can help identify the causes of epilepsy.
Diagnosis of Seizure Types
Misdiagnosis
Some patients may not find relief from seizure medication because they have been misdiagnosed. This can occur in situations such as:
- Seemingly typical seizure behaviors generated by psychological mechanisms in the absence of epilepsy
- Brief bursts of bizarre behaviors, which can occur in psychotic episodes or other psychiatric conditions, which are in fact manifestations of epileptic seizures
- Parasomnias and other seizure-like, non-psychiatric conditions that are mistaken for epilepsy
Improving Diagnostic Accuracy
In order to more accurately diagnose epilepsy and seizure disorders, the Emory Epilepsy Center uses a monitoring unit with continuous video-EEG monitoring. Continuous monitoring can improve diagnostic accuracy when the diagnosis of epilepsy, particular seizure type, or location of onset is not clear by routine or prolonged EEG recordings.
With more accurate diagnoses, physicians are better able to select the most effective medications and possible surgical treatment options. Accurate diagnosis also may lead to the discontinuation of medications that have been causing drowsiness, impaired thinking, or other adverse effects.
Therapeutic Services
Anti-Epileptic Drug Therapies
Anti-epileptic drugs can control seizures completely in more than two-thirds of epilepsy patients. In many cases, an epilepsy specialist must make adjustments to standard drug regimens in order to achieve complete seizure control.
Some patients may want to participate in clinical trials of investigational anti-epileptic drugs at the Emory Epilepsy Center. The Center also offers expertise with patient groups that typically experience special problems with these medications, such as pregnant women, children with learning or behavioral problems, and the elderly.
Epilepsy Surgery
The Emory Epilepsy Center has been very successful with the use of surgery to treat certain cases of epilepsy. For example, temporal lobe epilepsy, the single most common type of epilepsy, typically responds well to selective amygdalo-hippocampectomy. Other types of epilepsy can respond well to different surgical procedures, such as topectomy or corpus callosotomy. While not every patient is a surgical candidate, epilepsy surgery now offers hope in selected patients whose seizures cannot be controlled with medication alone.
Vagus Nerve Stimulation
The Emory Epilepsy Center has expertise with this procedure, which is designed to block seizure-producing electrical activity in the brain via stimulation of the vagus nerve. The vagus nerve stimulator is an excellent alternative for patients who have medically refractory seizures but are not surgical candidates.
Rehabilitative (Neuropsychological) Services
Our center also offers psychological services to help manage decreased memory, attention, or problem solving associated with chronic epilepsy. Specific services include:
Neuropsychological assessment to help identify the parts of the brain that are involved in generating seizures and to detect decreases in memory, attention, problem solving, and other mental abilities associated with epilepsy or epilepsy surgery.
Specialized testing for patients who are candidates for surgery. This specialized testing includes the "Wada Test," which is a procedure that helps in determining the risk to memory and language abilities from surgery. These specialized tests also include electrical mapping of brain areas to help the neurosurgeon plan the surgery itself.
Cognitive rehabilitation to assist patients in learning to compensate for problems in memory, attention, and reasoning so that patients may work and live up to their full potential.
Evaluation and referral to psychologists and psychiatrists in the community for patients who have emotional or behavioral concerns related to their epilepsy.
