More about epilepsy

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What is epilepsy?

Epilepsy is a neurological condition involving the brain and makes people susceptible to having recurrent, unprovoked seizures. A seizure occurs when parts of the brain receive a burst of abnormal electrical signals that temporarily interrupt normal brain function.

Anything that overstimulates the normal connections between nerve cells in the brain can cause a seizure. This includes a high fever, low blood sugar, high blood sugar, alcohol or drug withdrawal, or a brain concussion. If a person has two or more unprovoked seizures, he or she has epilepsy. Even after one seizure, someone can be considered to have epilepsy if they have a brain injury.

There are many different types of seizures, and they are classified by the amount of brain that is affected. Two broad categories of epileptic seizures are generalized and focal. Within these categories, there are many different seizure subtypes.

Symptoms
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General symptoms or warning signs of a seizure may include staring, jerking movements of the arms or legs, stiffening of the body, loss of consciousness, breathing problems, loss of bowel or bladder control, not responding to noise or words, appearing confused or in a daze, rapid eye blinking, or other sensory and behavioral abnormalities. Seizures may cause hallucinations, feelings of panic, out of body experiences, and episodes of intense déjà vu.

Sometimes there are minimal to no external signs. Some, but not all, have a preceding warning (aura). The full extent of the seizure may not be completely understood immediately after onset of symptoms but may be revealed with a comprehensive medical evaluation and diagnostic testing.

Evaluation
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The first line of defense against epileptic seizures is antiseizure medication. Fortunately, most people with seizures respond to one of the first two medications they are prescribed. About a third of people, however, continue to have seizures despite trying reasonable doses of reasonable medications, and they need a thorough evaluation at a Comprehensive Epilepsy Center like Spectrum Health.

An important step in the evaluation of persons continuing to have seizures is video-EEG monitoring. This allows the epilepsy specialists to determine whether the seizures are due to epilepsy or due to a mimicker of epilepsy.

Mimickers of epilepsy include a wide range of disorders from so-called physiologic mimickers like syncope (fainting) or narcolepsy (a sleep disorder) to non-physiologic or psychogenic mimickers caused by the body’s physical response to stressful thoughts and experiences.

When seizures are determined to be epileptic in nature, they are classified as being focal (starting in one hemisphere) or generalized (starting simultaneously in both hemispheres of the brain). This is an important distinction since medications designed to treat one type of seizure could make the other type worse. Epilepsy specialists work with you to define an accurate diagnosis and treatment plan specific to you. Treatment plans could consist of a simple adjustment in antiseizure medication or could involve recommendation for more definitive treatment like epilepsy surgery.

Diagnosis
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Spectrum Health System offers unique and comprehensive diagnostic technologies and assessments for epilepsy and seizures including:

  • Magnetoencephalography (MEG)
  • Video-EEG monitoring (inpatient and outpatient)
  • Functional cortical mapping
  • Evoked potential studies
  • Intraoperative electrocorticography
  • Brain mapping
  • Intracarotid amobarbital procedure (Wada testing)
  • PET, interictal SPECT, and ictal SPECT scans
  • MRI and functional MRI
  • Neuropsychological testing
Treatment options
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Epileptic surgery can safely and effectively reduce or eliminate seizures. The past decade has witnessed many advances in the surgical treatment of epilepsy. These surgeries vary in the degree of invasiveness. The neurosurgeons at Spectrum Health Comprehensive Epilepsy Center are experienced in and expert at each of these forms of surgery. They work hand in hand with the epileptologists to define an individual surgical plan for each patient.

Surgical treatments can be divided into two broad categories: neuromodulation and resective/ablative.

Neuromodulation

Neuromodulation involves implanting a medical device to stimulate the brain. These devices perform two functions. They have an acute disruptive effect where they can interrupt a seizure. Additionally, they have a long-term neuromodulatory effect whereby they train the brain to have progressively fewer and less severe seizure over time. Examples of this technology includes the vagus nerve stimulator (VNS), deep brain stimulator (DBS), and responsive neurostimulator (RNS). The epilepsy neurosurgeons at Spectrum Health have extensive experience implanting each of these devices.

Resective / ablative

Resective/ablative surgical options are ones that are most likely to cure your epilepsy. To be a candidate for one of these surgeries, your epileptologist will perform a number of tests designed to prove that your seizures are coming from one part of the brain and that the seizure-causing part of the brain can be removed without causing any problems. In brief, after epilepsy surgery we want you to be the same person leaving the hospital as the one who came in with one exception … no more seizures.

Myths and realities

Obstruction
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Myth

If someone’s having a seizure, you should hold them down and put something in their mouth so they don’t swallow their tongue.

Busted

You can’t swallow your tongue during a seizure. It’s physically impossible. Don’t restrain someone having a seizure and don’t force anything into their mouth. Just gently roll the person onto one side, support their head, protect them from injury and make sure their breathing is OK. Most seizures end on their own, within seconds or a few minutes.

Mortality
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Myth

You can’t die from epilepsy.

Busted

Uncontrolled seizures are associated with a scary phenomenon called sudden unexpected death in epilepsy or SUDEP. It is very important that uncontrolled seizures be evaluated and treated in order to reduce the risk of SUDEP. While death from epilepsy is rare, about 1 in 1,000 people with epilepsy die from SUDEP each year. People can also die from prolonged seizures. Make no mistake—epilepsy is a serious condition.

Quality of life
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Myth

People with epilepsy can’t live a full, normal life.

Busted

Epilepsy can affect a person’s lifestyle, but most people with epilepsy can do the same things that people without epilepsy can do. People with seizure disorders are found in all walks of life. There may be some types of jobs that they can’t do because of possible safety concerns.

Genetics
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Myth

If you have epilepsy, your children will have it.

Busted (mostly)

Most children of people with epilepsy do not develop seizures or epilepsy. However, certain forms of epilepsy are thought to have a genetic link. Since genes are passed down through families, some people may be at higher risk.

Treatment
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Myth

Epilepsy can’t be effectively treated.

Busted

There are many ways to treat, minimize, control and even—under the right conditions—eliminate the symptoms. Anti-epileptic medications do a great job of controlling seizures in about two-thirds of patients. For the remaining third, new surgical breakthroughs may be an option.

Our team

Spectrum Health is West Michigan's first Level 4 epilepsy center as designated by the National Association of Epilepsy Centers (NAEC). We have non-invasive diagnoses and innovative treatments to help get seizures under control.

Our Comprehensive Epilepsy Program has a team of epileptologists (epilepsy specialists), nurses, medical assistants, EEG technologists, social workers, counsellors, nurse practitioners, neuropsychologists, and epilepsy neurosurgeons who are ready to address all of your seizure and epilepsy-related issues.

At the Forefront of Epileptic Care

Here's how your provider can make a referral on your behalf