Epilepsy

Epilepsy is a common neurological disorder that causes recurrent seizures.

Seizures occur when there is an imbalance in the electrical activity of the brain. The malfunction may be in a small area of the brain or spread to the entire brain.

Epilepsy usually begins in childhood or adolescence. About 2.3 million people have seizures or epilepsy.

Epilepsy can be hereditary and can be associated with head injury, birth trauma, brain infections like meningitis and encephalitis, brain tumor or deformity, stroke, very high fever or withdrawal from drugs.

Symptoms

There are 2 main categories of epileptic seizures.

• Generalized
• Partial

Generalized seizures involve a loss of consciousness and affect the whole body. While partial seizures do not necessarily involve the loss of consciousness, they can lead to a generalized seizure.

In addition to seizures, symptoms of epilepsy may include mood changes and intense feelings of fear or déjà vu, fatigue, jerking or twitching of arms and legs, an aura, flashing lights or noises.

Seizures may occur rarely or every day. Many people with epilepsy have no symptoms between seizures and lead normal lives. Some people have no symptoms for years and may be weaned off medication.

Diagnosis

To diagnose epilepsy, a doctor will study the patient’s history, do thorough physical and neurological evaluations and run a variety of tests.

Tests may include magnetic resonance imaging (MRI) to produce pictures of tissues in the brain, an electroencephalograph (EEG) to record electrical impulses of the brain, an electrocardiogram (ECG) to monitor the heart, and blood tests to exclude other diseases.

Our 6-bed Epilepsy Monitoring Unit, the most modern in the state, is dedicated to confirming a diagnosis of epilepsy and pinpointing seizure activity and origin.

WFUBMC Approach

Wake Forest Baptist Medical Center is recognized internationally for the medical management of epilepsy. Our physicians routinely serve as faculty for the J. Kiffin Penry Minifellowship Program, attended by physicians from around the world.

Because of our leadership in medication development, patients in our Epilepsy Clinic have access to the newest medications first. Our epileptologists, including specialists in pediatric epilepsy, are experts in selecting the drug combinations most suitable for each patient.

When medication alone can't control seizures, we evaluate patients for other treatment options, such as surgical removal of the epileptic focus or implantation of the vagal nerve stimulator. This approach is especially beneficial for children with epilepsy, who can be spared the learning and developmental problems associated with poor seizure control.

Surgical removal of the epileptic focus has been successful and safe in adults and children of all ages. In the first randomized, controlled trial of surgery for epilepsy, researchers found that surgery is far more effective than medical therapy for treating drug-resistant epilepsy (New England Journal of Medicine, August 2, 2001).

Complete seizure control is achieved in 70 to 80 percent of patients; another 10 to 15 percent have a significant reduction in frequency and severity.

The vagal nerve stimulator, which controls seizures by sending electrical pulses to the vagus nerve, can be implanted on an outpatient basis using a single incision. The Medical Center was instrumental in the 9-year research effort that led to the device's approval and was first in the United States to implant the device in a human.

Request an appointment online today to receive more information about your personal health and learn how Wake Forest can help.