Epilepsy is a neurological disorder that causes abnormal electrical activity in the brain resulting in recurrent seizures. It is estimated that over 40 million people in the world may suffer from epilepsy. Epilepsy affects children, adults, and seniors and can be genetically present from birth or caused by a head injury, brain tumors, or infectious diseases. In many cases, the cause cannot be discovered.

The Emory Epilepsy Center has helped develop effective epilepsy treatments resulting in the control of seizures for up to 80% of epilepsy patients.

About Epilepsy & Seizures

Seizures are sudden events of abnormal brain function, which are typically brief but can occur repeatedly. Abnormal brain functions that can occur during seizures include:

  • Complete or partial loss of consciousness
  • Involuntary jerks, tremors, or other simple movement
  • More complex, but involuntary movements, such as turning in circles
  • Confusion or nonsensical speech
  • Unusual sensations in the head or body
  • Loss of ability to speak or understand speech
  • Memory loss

Types of Seizures in Epileptic Patients
Most people with epilepsy have more than one type of seizure over the course of their illness. Accurate seizure diagnosis is necessary in order to achieve the best epilepsy treatment.

  • Epileptic seizures are caused by rhythmic electrical discharges of brain cells. When only a small area of the cortex (higher part of the human brain) is involved in the beginning of the seizures, it is termed "partial onset." When the entire cortex is involved in the beginning of the seizures, it is termed "generalized onset."
  • Generalized tonic-clonic seizures ("generalized convulsions" or "grand mal" seizures) can start either as partial or as generalized onset, but in either case involve complete loss of consciousness and jerking movements of the entire body.
  • Partial-onset or generalized-onset seizures can take on many other forms in addition to generalized tonic-clonic seizures, including simple staring spells with brief loss of consciousness but no abnormal movements, seizures with complex body movements, and various other types.

Non-epileptic seizures can be caused by impaired blood flow to the brain, sleep disorders, psychological disturbances, and various other brain disturbances. Non-epileptic seizures are not caused by epileptic, electrical discharges of brain cells.

Diagnosing Epilepsy

For many patients epileptic seizures and non-epileptic seizures cause the same types of feelings, movements, and other behaviors, but EEG recordings can distinguish epileptic from non-epileptic seizures. Such EEG recordings usually are performed in an epilepsy monitoring unit with continuous digital video recording.  Many patients have a combination of epileptic seizures and non-epileptic seizures. Video-EEG monitoring can be used to show which seizures should be treated with epilepsy medications and which seizures are non-epileptic and require a different form of treatment. A high degree of expertise is necessary to interpret Video-EEG recordings correctly the expertise of advanced training and years of experience such as that represented in the faculty of the Emory Epilepsy Center.

The Emory Epilepsy Center offers comprehensive epilepsy diagnosis, treatment, and rehabilitation 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.

To more accurately diagnose epilepsy and other seizure disorders, the Emory Epilepsy Center uses an innovative patient 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.

Epilepsy Treatments

Anti-Epileptic Drug Therapies

Anti-epileptic drugs can control epileptic 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.

The Emory Epilepsy Center also offers a variety of 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. As part of our multidisciplinary approach to care, Epilepsy treatment is a specialty of our neurosurgery team.

Vagus Nerve Stimulation

The Emory Epilepsy Center has expertise with this form of epilepsy treatment, 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 epilepsy surgical candidates.

Specialized testing

The Emory Epilepsy Center offers specialized testing to patients who are candidates for epilepsy 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.

Rehabilitative (Neuropsychological) Services

The Epilepsy 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.
  • 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 relaled to their epilepsy.

Emory Epilepsy Center

Since 1994, the Emory Epilepsy Center has been one of the nation's leading institutions in the study and treatment of epilepsy. Our team of specially trained neurosurgeons and neurologists (epileptologists) provide epilepsy diagnostic services, therapy, and surgical treatment for both adult and pediatric epilepsy patients. The Emory Epilepsy Center is part of the Emory School of Medicine, globally recognized for medical research and physician training, and Emory Healthcare, one of the nation's leading health care systems.

The Emory Epilepsy Center staff sees over 7,000 patients each year from around the nation for consultation and epilepsy treatment. Our complete range of services includes diagnostic testing and the latest treatments, from anti-epileptic drug therapy to vagus nerve stimulation to brain surgery. In addition, our neurophysiologists work with patients to manage the special emotional and psychological stresses that are often the byproduct of seizure disorders such as epilepsy.

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