Epilepsy Center

About 70 percent of epilepsy patients can achieve complete seizure control using anti-epileptic drugs. The team of specialists at the Emory Epilepsy Center works with you to choose the right medications and make adjustments to gain full seizure control.
The Center offers additional expertise with patient groups that may experience unique problems with these medications, such as:

• Older adults who may have concerns associated with aging or undesired drug interactions
• Pregnant women and those considering pregnancy
• Those with learning or behavior difficulties in school

Every anti-epileptic medication can produce side effects. Our clinicians will work closely with you to develop a treatment plan that provides the most significant seizure control with the fewest side effects.

Stereotactic Laser Ablation (SLA) – A technique guided by continuous stereotactic EEG (sEEG) monitoring to map brain activity in real-time. SLA enables physicians to target the small structures in the brain causing seizures and remove them with pinpoint precision. The procedure is a safe, less-invasive surgical alternative for some patients with medication-resistant epilepsy and is an effective method of delaying surgical treatments for others.

Some types of epilepsy cannot be successfully treated with medications or with other minimally invasive techniques. In these cases, epilepsy surgery is often the best chance of seizure control. Surgery is generally considered only after you have tried at least two anti-seizure medications without satisfactory results.

Epilepsy surgery involves the removal of a small area of the brain cortex where electrical seizures begin. These carefully planned procedures are based on a comprehensive EEG, brain imaging and neuropsychological tests to avoid injury to areas of the brain that support motor activity, language, memory and other important functions.

A variety of highly specialized surgical techniques are available to patients, and our skilled and experienced epilepsy neurosurgeons have some of the best patient outcomes in their field. Approximately 80 percent of patients with temporal lobe epilepsy (the single most common form of epilepsy) gain complete control of their seizures after surgery, while most of the remaining 20 percent report significant improvement.

Other types of epilepsy surgery, in addition to temporal lobe surgery, must be individually determined for the particular patient.

Another possible treatment option for those with drug resistant epilepsy is neurostimulation which provides electrical stimulation to the brain.

• NeuroPace/Responsive Neurostimulation (RNS) – The RNS Neurostimulator is a small, battery-powered device surgically implanted in the skull. Electrodes placed within the seizure focus detect seizure activity and deliver a small pulse to prevent a seizure before it happens. RNS is an excellent alternative for patients with drug-resistant seizures who are not candidates for surgery.
  
• Deep Brain Stimulation (DBS) – Similar to RNS, deep brain stimulation (DBS) utilizes electrodes implanted deeper into the brain to treat more serious and debilitating cases of epilepsy. The Emory Epilepsy Center was among the first programs in the nation in 2018 to bring patients relief using this groundbreaking technique.
  
• Vagus Nerve Stimulation (VNS) – This procedure is designed to block seizure-producing electrical activity in your brain via the vagus nerve. This nerve, which is located in your neck, is believed to contain fibers that are connected to areas of your brain. The Vagus Nerve Stimulator (VNS) is an excellent alternative if you have medically refractory seizures but are not a surgical candidate. VNS involves the use of a small generator, similar to a cardiac pacemaker, which is implanted into the left cervical region of your chest and attached to a lead that is inserted and connected up to the vagus nerve. The generator should automatically stimulate the nerve and block the abnormal messages to your brain that are causing seizures. This was the first FDA-approved electrical stimulation treatment for epilepsy. VNS can help you gain better seizure control for a wide variety of seizures and improve your memory, mood or interictal alertness*. And fortunately, VNS does not cause systemic side effects like many antiepileptic medications do.

*The same chemicals and paths that slow or stop seizure activity also lower levels of other brain activity. When seizures are controlled via medication or therapy, some patients experience short episodes of depression and anxiety called interictal disorders that seem to occur when they would have normally had a seizure.

The Emory Epilepsy Center also offers psychological services to help manage the decreased memory, attention or problem solving associated with chronic epilepsy. Specific services include:

• BRITS Program – A specialized treatment program for patients with psychogenic non-epileptic spells. Trained therapists perform cognitive behavioral therapy geared specifically toward these patients with the goal of identifying the cause and preventing future spells.
  
• Cognitive Rehabilitation – Assists patients in learning to compensate for problems in memory, attention and reasoning.
  
• Neuropsychological Assessment – Helps 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," a procedure that helps determine the risk to memory and language function after epilepsy surgery. Cortical mapping, another specialized procedure, is performed by the neuropsychologist and the epilepsy doctor. This procedure maps brain function prior to surgery, helping prevent permanent neurologic damage.

As one of the only Level-4 epilepsy centers in the southeastern United States, the Emory Epilepsy Center is uniquely qualified to manage the care and treatment of especially vulnerable patients, including:

• Critically ill patients
• Individuals with learning or behavioral health challenges
• Older adults
• Pregnant women

When necessary, the Center's specialists are also available to collaborate with other clinicians to ensure the best possible overall care for individuals in these special patient groups.