Epilepsy can often be a frightening condition, but many patients lead normal lives. It affects the central nervous system, disrupting brain activity and causing seizures that sometimes result in loss of awareness or consciousness.
The loss of control can be very scary and dangerous for patients, frequently limiting the ability to drive and making other simple activities perilous, such as walking or swimming. But there are treatments to manage the disorder, and the majority of patients benefit from taking anti-seizure medications.
At Holy Name Medical Center, we provide intimate and personalized care that puts patients at ease while offering advanced diagnostics and treatments. We have an excellent neurophysiology lab, where patients can get the diagnostic testing they need. Our epileptologists, neurologists, EEG technicians, neuropsychologist and caregivers deliver the latest and best treatment options with a personal touch that can be missing at bigger medical centers.
Seizures Vary Widely
Epilepsy can develop in any person at any age, but it is more common in children and older people; men are slightly more likely than women to develop it. While epilepsy is a lifelong condition for many, some outgrow it after childhood.
Seizures are like an electrical storm or fire in the brain. Anyone’s brain can have a seizure due to certain medical causes, such as a high fever, low sugar, medication effects or withdrawal. Epilepsy is when the brain has a seizure under normal conditions.
There are many causes, including genetics, head injury, stroke, dementia and more. Frequently, we don’t know the cause. Focal, or partial, seizures appear to result from a disturbance in one part of the brain and are more common later in life when damage to the brain may have occurred. Generalized seizures may start anywhere in the brain.
Seizure symptoms vary widely, from staring blankly to limbs twitching, to the entire body convulsing. Some patients experience auras, deja vu, a rising sensation in the stomach, dizziness, tingling or flashing lights. Others may lose consciousness.
Usually seizures resolve themselves in a couple of minutes. If they persist for more than five minutes, a patient may need rescue medication. Seizures that go on longer than 30 minutes can permanently damage the brain. Medical attention is key.
Diagnosis and Treatment
An EEG (electroencephalogram) is the most common test used to diagnose epilepsy. Electrodes are attached to the scalp with paste to record the brain’s electrical activity. Brain wave patterns are generally changed for those with epilepsy. Advanced imaging, such as MRI, and blood tests also are used.
There are at least two dozen medications now used to control seizures, and they have gotten more precise in recent years – targeting the neuron sensors and transmitters that need to be controlled.
At Holy Name’s Adult Epilepsy Center, we try to strike a balance in terms of minimizing seizures and the side effects of the medication, which include drowsiness and slowed cognition. We want patients to be on the minimum amount of medication needed to mitigate sedation and memory loss. Medication alone will control seizures for about 65 percent of patients.
Patients with focal seizures may also be candidates for curative surgery if the problem comes from a region of the brain where removal of lesions is not likely to cause other problems. There are several other surgeries that can help reduce seizures, one of which involves implanting a device that acts like a pacemaker to prevent seizures by sending regular, mild pulses of electricity to the brain via the vagus nerve in the neck. This treatment can also provide pain relief.
Epilepsy can be frightening and disorienting, and there is often a stigma attached to it; many patients are prone to depression. But the news isn’t all bad – there are effective options to control seizures, and here at Holy Name we treat the disorder from every angle – to treat the whole patient.
Joseph I. Petrsoric, MD, is board-certified in neurology and epilepsy. He specializes in the diagnosis and treatment of epilepsy, as well as other neurologic conditions. He is medical director of the National Association of Epilepsy Centers/Adult Epilepsy Center at Holy Name Medical Center in Teaneck. To schedule an in-person or telemedicine appointment, contact (201) 833-7208 or HolyNameMedicalPartners.org