Epilepsy is defined as unprovoked recurrent seizures that are caused by abnormal brain electrical activity. If not fully controlled, seizures can have a negative impact on a person’s health and wellbeing. Epilepsy is the 4th most common neurological condition in the United States. About 1 in 26 Americans people are affected by epilepsy.
Seton Healthcare Family’s Comprehensive Epilepsy Program is the only Level 4 Epilepsy Center in Central Texas. Our designation as a Level 4 Epilepsy Center is based upon guidelines from the National Association of Epilepsy Centers.
Wellness & Prevention
Epilepsy is a group of disorders of the central nervous system that cause a disruption in brain activity. This leads to seizures or sudden odd behavior or sensations. Sometimes, you can lose consciousness in an epilepsy attack.
The exact cause of epilepsy is unknown. For this reason, it’s important for people with epilepsy to take control of their health, which may help minimize future seizures. There are many factors that could trigger seizures:
- Skipping a dose of anti-seizure medication
- Changing medications
- Drug or alcohol use or abuse
- Not getting enough sleep or changes in sleep schedule
- Sensory overstimulation, like flashing bright lights
- Emotional issues like stress or anxiety
- In women, hormonal changes during menstrual cycle or pregnancy
It’s also important to learn the warning signs of a seizure so you can get to a safe place and follow your seizure response plan. Many people notice what’s called an “aura” before a seizure. This is hard to describe and is often different for everyone, but may include:
- Unusual taste in the mouth
- Strange, strong smells
- Visual disturbances, like blurred vision or seeing strange lights
- Audible buzzing, hearing noises that don’t exist, or noticing a heightened sense of hearing
- Feeling like you’re not yourself or other odd emotions that are hard to describe
- Memory lapses
- Déjà vu
- Feeling suddenly tired, confused or weak
- Numbness or tingling
Some warning signs occur only minutes before a seizure while others appear hours or even days before. It’s common for an individual to experience the same type of aura before each seizure.
It’s a good idea to keep a “seizure diary” where you can track episodes and share that information with your healthcare provider. Items to include can range from the times and dates that a seizure occurred, to a log of your diet, sleeping patterns and daily moods. This can help identify the triggers that are specific to you, and may help your doctor better understand how to treat your epilepsy.
Recurring seizures are the main sign of epilepsy. As our understanding of epilepsy and seizures deepens with research, the definition of epilepsy and seizures also changes over time. A correct diagnosis of seizure and epilepsy type is an essential first step in receiving the best care.
There are two main types of seizures: focal onset seizures and generalized seizures.
- Focal onset seizures start in one part of the brain and may or may not spread to other parts of the brain or the entire brain.
- Generalized seizures, at their onset, involve the entire brain cortex at the same time.
Classification of epilepsy syndromes is determined by the type of seizures, age of onset, EEG results and other factors.
Many other conditions may seem the same as seizures at first, so an accurate diagnosis is important. While individual history is the first step in an epilepsy diagnosis, more advanced testing is sometimes needed.
There are several ways to test for and diagnose epilepsy:
Because epilepsy can affect a person in several different ways, a baseline of normal cognitive ability needs to be established to find how the brain is affected by seizures. A neuropsychological evaluation begins with standard testing to look at memory, attention and problem-solving skills as well as physical senses. This is an out-patient process that takes about an hour. Later, a follow-up will be scheduled to go over the results with a neuropsychologist.
Neuroimaging studies give your doctor a way to look at your brain in order to observe the impact of a seizure. These tests can reveal the place in the brain where seizures are taking place, the activity level in specific brain areas or show physical abnormalities in the brain that could be responsible for the seizures.
- CT Scan: A computerized tomography (CT) scan can show a cross-section of the brain using X-rays.
- MRI: An MRI (magnetic resonance imaging) uses a magnetic field to create a three-dimensional picture of the brain. An MRI may be performed to show more information about the results of another type of test, such as a CT scan.
- MEG: A magnetoencephalography study (MEG) measures very small magnetic field changes. These changes are produced by electrical abnormalities in brain function.
- PET: A positron emission tomography (PET) study uses a radioactive tracer to show if part of the brain has a lower metabolism than other parts.
- SPECT: The SPECT (single-photon emission computed tomography) study looks at blood supply in the brain during a seizure. The results are compared against images of the brain in its normal state.
- EEG: The electroencephalogram (EEG) records electrical activity from the surface of the brain. There are many different kinds of EEGs.
Epilepsy Monitoring Unit
Seton Brain & Spine Institute’s Comprehensive Epilepsy Program also offers an Epilepsy Monitoring Unit (EMU). This is an in-patient hospital unit where people are admitted for continuous video EEG recording. Full-time monitoring lets doctors better capture seizure events for more accurate classification. A stay in the EMU usually lasts between three to five days.
During a Wada test, named after the developer of the procedure, one half of the brain is put to sleep while the other half is tested. After that, the procedure is repeated and reversed to test the other half. A Wada exam may include a number of other tests, including EEG monitoring, a neuropsychological evaluation, an angiogram and more. The test takes a full day.
Our epilepsy program, which serves the Greater Austin area, includes many experts in epilepsy care with a range of different specialties. Together, our specialists work as a team from diagnosis through treatment and follow-up care to deliver the best possible outcome. Often, a combination of treatments can mean a higher quality of life to the epileptic person.
- Medication: Anti-seizure medications are typically the first line of defense in preventing seizures. Sometimes more than one medication may be prescribed.
- Epilepsy Surgery: If medication isn’t helping, has stopped working or causes serious side effects, epilepsy surgery may be an option. Surgery can remove the part of the brain where seizures take place.
- Dietary Approaches: A restricted diet that is medically monitored may help control seizures. This can be a good option in children who don’t respond to medication.
- Psychiatric Services: People with epilepsy tend to have a higher chance of suffering from mental health issues, including anxiety and depression. An epileptic person may also experience emotional strain as a result of the stress and restrictions imposed by the condition.
When facing difficult decisions about how to best treat epilepsy, a visit with the brain and spine specialists at Seton can be helpful. Our team works to create a complete treatment plan to help people with epilepsy reclaim their lives. We are dedicated to providing people with freedom from seizures and helping them experience the confidence and happiness that a seizure-free life can offer.
Epilepsy Treatment Research
The Seton Healthcare Family proudly produces some of the latest epilepsy research right here in Austin. Seton’s doctors use the latest, most innovative treatments possible, and their research enables us to remain at the forefront of excellence in epilepsy treatment and technology.
Because epilepsy symptoms are controlled rather than cured, treatments are ongoing. The most important thing that an epileptic person can do to improve their quality of life is to make their health a top priority:
- Take any anti-seizure medication as prescribed. Always talk to your doctor before making any medication changes.
- Be sure to get plenty of sleep.
- Avoid any known seizure triggers.
- Eat right and stay active, both of which can help manage the emotional toll of living with epilepsy.
- Wear a medical alert bracelet so you’ll be properly treated in case of a seizure.
In addition to these self-care steps, be sure to educate your family and friends about your condition, and let them know ways they can help. It’s also critical that those close to you know how to help during a seizure and what they should expect.