Epilepsy and Seizure Disorders

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Pinpointing the diagnosis of epilepsy with the greatest accuracy possible

Epilepsy is a neurological condition involving the brain that makes people more susceptible to having recurrent seizures. It is one of the most common disorders of the nervous system and affects people of all ages, races, and ethnic background. Almost 2.2 million Americans live with epilepsy.

At Hackensack Meridian Health, specialized services such as epilepsy monitoring aim to help children and adults gain control of seizures.

Specific treatment for a seizure will be determined by your healthcare provider based on:

• Your age, overall health, and medical history
• Type of the seizure
• Frequency of the seizures
• Your tolerance for specific medicines, procedures, or therapies
• Expectations for the course of the condition
• Your opinion or preference

Treatment of a seizure

Specific treatment for a seizure will be determined by your healthcare provider based on:

• Your age, overall health, and medical history
• Type of the seizure
• Frequency of the seizures
• Your tolerance for specific medicines, procedures, or therapies
• Expectations for the course of the condition
• Your opinion or preference

Hackensack Meridian Health‘s goal is to control, stop, or decrease the frequency of the seizure, without interfering with the normal activities of daily living. Treatments to manage epilepsy and seizures may include:

Medicines
There are many types of medicines used to treat seizures and epilepsy. Medicines are selected based on the type of seizure, age of the patient, side effects, the cost of the medicine, and the adherence with the use of the medicine.

Medicines can be used at home, usually taken by mouth, or can be given rectally. If the person is in the hospital with seizures, medicine may be given by injection or intravenously by vein.

It is important to take your medicine on time and as prescribed by your healthcare provider. Different people use up the medicine in their body differently, so adjustments, such as schedule and dosage, may need to be made for the most effective seizure control.

While you are taking medicines, different tests may be done to monitor the effectiveness of the medicine. These tests may include the following:

• Blood work. Frequent blood draws testing is usually needed to check the level of the medicine in the body. Based on this level, the healthcare provider may increase or decrease the dose of the medicine to achieve the desired level. Blood work may also be done to monitor the effects of medicines on body organs.
• Urine tests. These tests are sometimes performed to see how the person’s body is responding to the medicine.
• Electroencephalogram (EEG). An EEG is a procedure that records the brain’s continuous, electrical activity by means of electrodes attached to the scalp. This test is done to monitor how the medicine is helping the electrical problems in the brain.

Vagus nerve stimulation (VNS)
Some people, whose seizures are not being well-controlled with seizure medicines, may benefit from a procedure called vagus nerve stimulation (VNS). VNS is currently most commonly used for people over age 12 who have partial seizures that are not controlled by other methods. VNS attempts to control seizures by sending small pulses of energy to the brain from the vagus nerve, which is a large nerve in the neck.

Side effects of VNS may include, but not are not limited, to the following:

• Hoarseness
• Pain or discomfort in the throat
• Change in voice

Surgery
Surgery is not a choice for everyone with seizures. Surgery may be considered in a person who:

• Has seizures that are unable to be controlled with medicines.
• Has seizures that always start in one area of the brain.
• Has a seizure in a part of the brain that can be removed without disrupting important behaviors, such as speech, memory, or vision.

Surgery for epilepsy and seizures is very complicated. The operation may remove the part of the brain where the seizures are happening, or, sometimes, the surgery helps to stop the spread of the bad electrical currents through the brain.

A person may be awake during the surgery. The brain itself does not feel pain. With the person awake and able to follow commands, the surgeons are better able to make sure that important areas of the brain are not damaged.