Neurology > Epilepsy

Epilepsy

Why choose Wayne Health for Epilepsy Care?

Wayne Health’s Adult Epilepsy Program offers the most advanced medical and surgical treatment for individuals with epilepsy and related disorders.  The Epilepsy program is affiliated with Wayne State University School of Medicine and the Detroit Medical Center and is strongly committed to clinical and translational research, academic teaching, and medical education training. Our dedicated multidisciplinary team provides comprehensive epilepsy care with a full range of specialists, including neurologists, epileptologists, neurosurgeons, neuropsychologists, neuropathologists, neuroradiologists, EEG technologists, and specialist epilepsy nurses. Although seizure control is a primary treatment objective, optimizing quality of life is also of paramount importance. Our program has been designated as a Level 4 Epilepsy Center, the highest designation, by the National Association of Epilepsy Centers.

Epilepsy services offered

  • A comprehensive evaluation for epilepsy
  • Specialized epilepsy care for women with epilepsy (Pregnancy and Epilepsy Clinic); for the elderly (Elderly & Seizure Clinic) and for epilepsy in those with autoimmune and genetic disorders.
  • Transition clinic accepting children with epilepsy as they grow into adulthood.
  • Dietary modulation for treatment of epilepsy
  • Extensive medical, neuropsychological and psychosocial evaluation
  • Participation in investigator-initiated research and ongoing clinical trials of new anti-epileptic medications
  • Neurodiagnostic testing at the Detroit Medical Center and Karmanos Cancer Institute which includes:
    • Epilepsy Monitoring Unit evaluation
    • Ambulatory EEG monitoring
    • High-resolution, volumetric MR imaging
    • Functional MRI (fMRI)
    • Intracarotid Sodium Amobarbital (Wada)Test
    • Positron emission tomography (PET) scanning with multiple tracers
    • Ictal and interictal Single Photon Emission Computerized Tomography (SPECT) scanning, with the ability to perform subtraction imaging and co-registration with MRI (SISCOM)
  • Broad range of surgical procedures, including vagal nerve stimulator (VNS) implantation, responsive neurostimulation (RNS) and epilepsy surgery using advanced EEG monitoring with intracranial electrodes.

Overview

What is epilepsy?

Epilepsy is a common condition that causes repeated seizures. The seizures are caused by bursts of electrical activity in the brain that aren’t normal. Seizures may cause problems with muscle control, movement, speech, vision, or awareness. In most cases, they don’t last very long. But they can be scary. The good news is that treatment usually works to control and reduce seizures.

Epilepsy is not a type of mental illness or intellectual disability.

Seizures may look scary or strange. But they don’t make a person crazy, violent, or dangerous. You can’t catch epilepsy from other people (like you can catch a cold), and they can’t catch it from you

Symptoms

The main symptom of epilepsy is repeated seizures that happen without warning. Without treatment, seizures may continue and become worse and happen more often over time.

There are different kinds of seizures. You may have only one type of seizure. Some people have more than one type. Depending on what kind of seizure you have:

  • Your senses may not work right. For example, you may notice strange smells or sounds.
  • You may lose control of your muscles.
  • You may fall down, and your body may twitch or jerk.
  • You may stare off into space.
  • You may faint (lose consciousness).

Not everyone who has seizures has epilepsy. Sometimes seizures happen because of an injury, an illness, or another problem. In these cases, the seizures stop when that problem improves or goes away

Risk Factors

Diagnosis

Diagnosing epilepsy can be hard. Your doctor will ask questions to find out what happened just before, during, and right after a seizure. Your doctor will examine you. You’ll have some tests, such as an electroencephalogram. This information can help your doctor decide what kind of seizures you have and if you have epilepsy.

Wayne Health’s Epilepsy team offers a full range of the most advanced diagnostic tests, including:

·    Video EEG monitoring

·    High-resolution volumetric MRI scanning

·    Positron emission tomography (PET) scanning with multiple tracers

·    Ictal and interictal Single Photon Emission Computerized Tomography (SPECT) scanning, with ability to perform subtraction imaging and co-registration with MRI (SISCOM)

·    Functional MRI (fMRI)

·    MR spectroscopy (MRS)

·    Other MR imaging modalities, utilizing the 3-Tesla unit

·    Intraoperative EEG monitoring

·    Neuropsychological evaluation, including intracarotid amybarbital (Wada) testing

These advanced tools allow Wayne Health epilepsy experts to establish seizure classification, to assess response to medical therapy, and to evaluate patients for epilepsy surgery.

Our approach to treatment

Wayne Health’s outpatient Epilepsy Clinics evaluate and treat patients with refractory epilepsy and are referral centers for patients across the state of Michigan. Specialty clinics for Pregnancy and Epilepsy (established in 2015) and Epilepsy in the Elderly (established in 2017) distinguish us from other centers. In collaboration with Children’s Hospital of Michigan, we have an established mechanism for transitioning patients from the pediatric to the adult epilepsy clinic to optimize continuity of care for a wide range of pediatric-onset epilepsies, including “benign” and genetic complex conditions.

While most patients with epilepsy can have good control of their seizures with the appropriate medications, about 20 to 30% of patients may become refractory (difficult to control) with medical treatment. When medical management fails to control seizures, our comprehensive epilepsy team may consider patients for epilepsy surgery and other non-medical treatment options.  Our team of subspecialty trained epileptologists will conduct a comprehensive evaluation and work with a multidisciplinary team to recommend different surgical options, including neuromodulation, disconnection procedures, or removal of the epileptic tissue and focus.

Therapeutic surgical options include:

  • Resection techniques
    • Lesionectomy
    • Temporal lobectomy/resection
    • Extra-temporal corticectomy/resections
  • Disconnection procedures
    • Corpus Callosotomy
    • Subpial Transections (in isolation or combined with a resection)
  • Stereotactic Laser Ablation
  • Neuromodulation
    • Vagus Nerve Stimulation (VNS)
    • Responsive Neuromodulation (RNS)

Advancing research and medical education

Physicians and researchers at Wayne Health are also faculty members of the Wayne State University School of Medicine who conduct research and clinical studies. This makes the latest treatments and clinical trials available to you sooner than other health providers without a medical school affiliation.

Participation in investigational, multicenter research trials of new antiepileptic medications is available for patients with difficult-to-control epilepsy.

For more information, please visit the links below at the WSU School of Medicine.

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