Epilepsy: Conditions & Treatments

Epilepsy is a disorder characterized by spontaneous, unpredictable seizures that are caused by a disturbance in normal patterns of electrical activity in the brain.

It is the fourth most common neurological disorder in the United States, after migraine headaches, stroke and Alzheimer's disease, according to the Epilepsy Foundation.

Seizures can range from relatively benign to life-threatening and severely disabling. Some people begin experiencing them in childhood while others have seizures that emerge later in life. Some seizures have a genetic component; others may be triggered by a traumatic brain injury.

A variety of anticonvulsant medications have shown success in controlling seizures in many people. Neuropsychological therapies and a specialized diet also can help. Other patients are helped by surgical intervention.

Conditions

At the UCI Health Comprehensive Epilepsy Program, we diagnose and treat all types of epilepsy — including idiopathic (genetic), symptomatic (cause known) and cryptogenic (cause unknown) — in patients 12 years of age and older. We have special expertise in helping patients with:

• Drug-resistant epilepsy, also known as medically refractory epilepsy
• Women with epilepsy whose seizures are affected by their menstrual cycles. This is also known as catamenial epilepsy.

Diagnostic evaluation

The key to improved control of an epileptic seizure disorder is an accurate diagnosis. Each case is unique. Our skilled physicians interview and examine each patient, then perform diagnostic tests to identify the type of seizure, locate its origins and determine the underlying cause, if possible.

Surgical treatments are usually preceded by more detailed testing to pinpoint the area of the brain that generates seizures, as well as nearby regions with important cognitive, motor and sensory functions. Our six-bed seizure monitoring unit, where patients are observed around the clock, is one of the region's only facilities equipped with highly sensitive instruments able to capture real-time sustained seizure activity within the brain. 

We use the latest technology for diagnostic testing, including:

• Electroencephalography (EEG)

An EEG test records the brain’s electrical activity and can help identify the type and location of seizures.

• Continuous video and EEG monitoring

Patients’ seizures are recorded and analyzed using synchronized digital EEG, video and audio recordings.

• Magnetic resonance imaging (MRI)

MRI scans produce detailed images of the brain’s structure, allowing physicians to look for abnormalities that may cause seizures. We use a Tesla high-resolution MRI for epilepsy evaluation, a technology not available at many other medical centers.

• Positron emission tomography (PET) and single-photon emission computer assisted tomography (SPECT) 

PET scans examine metabolic activity, while SPECT scans identify blood flow patterns. Each test may help identify a brain region causing seizures, particularly in patients with normal MRI scans.

• Magnetoencephalography (MEG)

Magnetoencephalography is a non-invasive imaging technique that measures the magnetic fields generated by electric currents produced by neurons in the brain. When combined with an MRI, MEG imaging can help pinpoint areas in the brain with the potential to generate seizures as well as areas of normal electrical activity in the brain.

• Wada test

This test is used to identify language and memory functions of the left and right sides of the brain. Our board-certified neurologists perform this study in patients who are being evaluated for epilepsy surgery.

Treatments

Medication

Nearly 70 percent of people who have epilepsy respond to medications. Sometimes a series of several different drugs may be tested over a period of time to find the one that works best and has the fewest side effects. Combinations of drugs may be tested as well. In an effort to develop new and more effective medications, certain patients may be eligible for enrollment in an experimental drug study.

Surgery

For the approximately 30 percent of epilepsy patients whose seizures cannot be controlled with medications, we offer every type of surgery for epilepsy, including advanced procedures not widely available elsewhere.

Surgical treatments are usually preceded by more detailed testing to pinpoint the area of the brain that generates seizures, as well as regions with important cognitive, motor and sensory functions.

Once the area is identified, state-of-the-art surgical techniques are used to remove or disconnect the precise location in the brain that is the focal point of the seizure. In types of drug-resistant epilepsy cases, about 70 percent of surgical patients may become seizure-free.

Vagus nerve stimulator (VNS)

Implanting a vagus nerve stimulator (VNS) is another option for controlling seizures in patients who have not been helped by drugs. The VNS is a small, programmable electrical device that is placed beneath the skin, usually in the chest area, and is linked by a wire connected to the vagus nerve in the neck. It emits an electrical signal that stimulates the vagus nerve, which can stop or lessen seizures. A majority of VNS patients experience a reduction in seizures after the procedure.

Additional services

At UCI Health, we also offer epilepsy services for women, who often experience heightened seizure activity during their menstrual cycles.

Other services include:

• Nutritional consultation for modified Atkins diets
• Close collaboration with your referring physician
• Convenient referral process

For more information or to make an appointment, please call us at 714-456-6203 or request an appointment online.