Epilepsy is a disorder of the brain that causes repeated, unpredictable seizures, generally beginning in childhood or early adulthood.
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What is Epilepsy?
Epilepsy is a disorder of the brain that causes repeated, unpredictable seizures, generally beginning in childhood or early adulthood. Epilepsy can lead to serious complications, including injury to the brain.
Epilepsy means the brain has formed abnormal electrical connections that disrupt normal brain function and cause seizures. It can be caused by an injury or illness that affects the brain, such as a stroke or brain tumor, or its cause can be unknown.
In adults, medication can frequently control epilepsy. However, if seizures persist after trying two drugs, our expert neurosurgeons may offer epilepsy surgery.
What Are the Signs and Symptoms of Epilepsy?
Epilepsy seizures usually begin between the ages of five and 20 but may occur at any age. The type and severity of epilepsy symptoms and seizures can indicate what part of the brain is affected by epilepsy.
It is important for anyone who has seizures despite taking medication to be seen by a doctor who specializes in epilepsy treatment, also known as an epileptologist. These doctors are trained in the use of imaging and other studies to diagnose the causes of epilepsy.
How Do You Diagnose Epilepsy?
Testing for epilepsy
An EEG (electroencephalogram) of the brain shows electrical activity, which can pinpoint the areas of the brain that are not behaving normally in patients with epilepsy. Since electrical activity in the brain may appear normal between epileptic seizures, your doctor may request a video EEG study, which is done during an inpatient visit in the Epilepsy Monitoring Unit at UPMC Presbyterian.
Diagnostic surgery
If you are a candidate for epilepsy surgery, UPMC neurosurgeons will also perform a full complement of diagnostic tests to determine if surgery is appropriate.
How Do You Treat Epilepsy?
Neurosurgeons at UPMC are able to help adult patients with epilepsy lead a normal life and control their seizures through the use of the following epilepsy treatment:
- Medications
- Surgery
- Implantation of stimulation devices
A full complement of advanced diagnostic tests are performed to help patients receive an accurate diagnosis and to determine whether surgical intervention is appropriate.
Medication
Usually, epilepsy medications can bring seizures under control. However, in at least one third of people with epilepsy, seizures persist despite trials of numerous drugs.
Epilepsy surgery may be an effective option if:
- Two different medications cannot help control a patient's seizures
- Medication side effects are not tolerable
Surgical treatment options
UPMC neurosurgeons offer a number of surgical options for adult patients with epilepsy:
- Diagnostic surgery called intracranial monitoring or stereo-EEG for localization of the seizure onset zone using
- ROSA® Robotic System – new robotic technology that allows for neurosurgeons to more accurately perform minimally invasive procedures for epilepsy and movement disorders
- Craniotomy for resection of seizure focus – surgical removal of the abnormal brain tissue causing seizures
- Laser ablation – minimally invasive surgery using focused heat to destroy the abnormal brain tissue causing seizures
- Vagus nerve stimulation (VNS) – a stimulator in the neck that can reduce seizure frequency
- Deep brain stimulation (DBS) – a brain stimulator that can reduce seizure frequency
- Responsive neurostimulation (RNS®) – a brain stimulator that can detect seizure activity and stimulate the brain in response, resulting in seizure reduction
- Other less commonly used surgeries including multiple subpial transections (MST), corpus callosotomy, and others are available to patients who may benefit from them
