There is Hope: Drugs and Surgery Can Help the Majority of People with Epilepsy
Sean Murray, of Fairfax, Virginia, was diagnosed with epilepsy at the age of 6, when he experienced his second seizure. The first seizure came when he was only 6 months old. However, epilepsy barely affected most of Murray's childhood, since he had only two or three minor seizures a year.
But starting at age 17, Murray's seizures became more frequent. "Over time, the seizures got worse, and the medications I had been on for a long time were not working as well," the now 34-year-old says.
For years Murray's life was unpredictable as the seizures continued to worsen. Then he met Pavel Klein, MD, a Holy Cross Hospital neurologist with specialty training in epilepsy, also known as an epileptologist.
"While many people with epilepsy can control their seizures with medication, some, like Sean, need to either fine-tune their medications or look at other treatment options," Dr. Klein says. "Seizures don't have to, nor should they, go uncontrolled."
Here's a look at some of the treatment options available to help patients control epilepsy:
Medications. A physician's decision of which drug to prescribe depends on what kind of seizure a person is having. One person's seizures will respond well to a particular drug, while another person will have seizures that continue. Some people experience side effects; others do not. It may take some time to find exactly the right dose of the right drug.
"My patients have the opportunity to participate in clinical trials to try new medications not yet available to the general public," Dr. Klein says. "This is particularly important for patients whose seizures have not responded to existing medications."
Surgical options. If seizure-preventing medications are not successful, brain surgery may be considered. If tests reveal that all of a patient's seizures originate from the same place in the brain, this area of the brain may be removed to relieve seizures without affecting other functions.
"Because tests revealed all of Murray's seizures originated from his right temporal lobe, he was an ideal candidate for right temporal lobectomy," says James Leiphart, MD, PhD, a neurosurgeon who specializes in epilepsy surgery. Murray underwent brain surgery with Dr. Leiphart at Holy Cross Hospital in June 2007 and has not had a seizure since.
"My life is more stable now," Murray says. "I'm working and going to school. I plan to get a bachelor's degree in information technology."
Implants. When medications are not working and surgery is not an option, patients may also consider having a vagal nerve stimulator (VNS) implant. This small device goes in the upper chest and stimulates a nerve in the neck to reduce seizure activity.
Murray stayed in Holy Cross Hospital's Epilepsy Monitoring Unit designed for the diagnosis and treatment of seizure disorders. "In this unit a core group of neuroscience clinicians assess, monitor and determine the best plan of care and evaluation for patients with epilepsy," Dr. Klein says.
Dr. Klein uses several painless imaging technologies to assess patients' brains in astonishing detail:
- Video EEG (electroencephalogram) monitoring simultaneously records a patient's behavior and the brain's electrical activity.
- Magnetic resonance imaging (MRI) creates pictures of the inside of the body and brain.
Positron emission tomography (PET) shows the brain's chemical activity.
- The Wada test determines the location of speech areas and memory function in the brain.
These tests provide a better understanding of how and where seizures originate in the brain and have led to a new generation of epilepsy drugs and surgical options.