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Many patients find themselves overwhelmed by the physical and emotional impact of uncontrolled seizures or intolerable medication side effects, making it difficult for them and their families to live normal lives. Fortunately, medical research into the intricate workings of the human brain has given new hope to these patients.

Evaluation

Effective treatment of any disorder first requires the correct diagnosis. Seizures and epilepsy often represent complex medical problems that require a multidisciplinary evaluation to properly identify the type of seizure and find the underlying cause. UC Irvine’s board-certified neurologists thoroughly interview and examine each patient and perform diagnostic tests. The specific tests required for diagnosis and treatment vary from one patient to another because each patient is unique.

Diagnostic tests include:

• EEG (Electroencephalography)

EEG is a method of recording electrical activity of the brain and is used to identify seizure type and location.
 

• Continuous video-EEG monitoring

During video-EEG monitoring, patients’ seizures are recorded and analyzed using synchronized digital EEG, video and audio recordings.

• MRI (Magnetic Resonance Imaging) Scans

MRI scans produce detailed images of the brain’s structure, allowing physicians to look for abnormalities that may cause seizures. UC Irvine uses the Tesla high-resolution MRI for epilepsy evaluation and implements specific epilepsy protocols for imaging. These details are necessary and available at UC Irvine but not at many other facilities.

• PET (Positron Emission Tomography) and SPECT  (Single Photon Emission Computer-Assisted Tomography)

PET scans specifically examine metabolic activity, while SPECT identifies blood flow patterns. Each test may be helpful in identifying a brain region causing seizures, particularly in patients with normal MRI scans.

• Wada Test

The Wada test is used to identify the language and memory functions of the left and right sides of the brain. Our board-certified neurologists perform this study in patients who are being evaluated for epilepsy surgery.

Treatment Options

Medical Treatment

Almost 70 percent of people with epilepsy respond to treatment with anti-epileptic drugs. Sometimes, a series of several different drugs may be tested over a period of time to find the one that works best and has the fewest side effects. Combinations of drugs may be tested as well. In an effort to develop new and more effective medications, certain patients may be eligible for enrollment in an FDA-approved experimental drug study.

Surgical Treatment

For those who require other options, the UC Irvine Comprehensive Epilepsy Program offers every type of surgery for epilepsy, including advanced procedures not widely available. Surgical treatments are usually preceded by more detailed testing to pinpoint the area of the brain that generates seizures, as well as regions with important cognitive, motor and sensory functions.

Once the area is identified, state-of-the-art surgical techniques are used to remove or disconnect the part of the brain that is the focus of the seizure. In certain cases, approximately 70 percent of patients may become seizure-free after surgery.

Vagus Nerve Stimulator (VNS)

Implanting a vagus nerve stimulator (VNS) is another option for controlling seizures in patients who have not been helped by drugs. With VNS, a small stimulator device is placed beneath the skin. The device emits an electrical signal that stimulates the vagus nerve and disrupts brain activity, effectively controlling seizures. The majority of patients have a reduction in seizures after the procedure.

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