Tests

Getting relief for intractable epilepsy starts with finding your seizure focus, the place in your brain where your seizures are coming from. To do this, we have many options, including:
 

• ​Electroencephalogram (EEG). Strip grids and depth electrodes are attached to the scalp to monitor the electrical activity of the brain.

• Epilepsy monitoring. Our computer-based monitoring equipment and epilepsy monitoring team will gather data before, during and after an epileptic event to help shape your treatment plan. 

• MRI (magnetic resonance imaging). Identifies structural changes in the brain that might cause seizures.

• Single photon emission computed tomography (SPECT scan). Shows a map of blood flow through different parts of the brain​.

Treatment

Before deciding on a course of treatment for you, we'll take into account your specific diagnosis and other factors to come up with an option that best fits your individual needs. We use a multi-disciplinary approach, which means bringing in experts from various fields and divisions to come up with a plan of treatment.

Generally, epilepsy treatment may include any of the following:
 

• Lesionectomy: The surgeon removes tumors or malformations of blood vessels in the brain identified as the primary source of your seizures. Using three-dimensional imaging and surgical localization techniques, the surgeon limits the size of the incision needed for the procedure. 

• Lobectomy: The most common of all surgical epilepsy procedures, this operation removes part of or an entire lobe of the brain. This is a safe, common procedure that uses tests to ensure no vital functions are controlled by any areas removed.

• Laser ablation: Your surgeon will guide laster interstitial thermal therapy (LITT) to target and destroy tumors and scar tissue in the area of the brain where your seizures originate from. 

• Deep brain stimulation (DBS): During this procedure, electrodes are implanted in your brain. The electrodes deliver electrical impulses to block or change the abnormal brain activity causing symptoms.  

• Vagus nerve stimulation (VNS): A stimulator (or pulse generator) is connected, inside the body, to the left vagus nerve in your neck. The stimulator sends regular, mild electrical stimulations through this nerve to help calm down the irregular brain activity that causes seizures.

• Functional hemispherectomy: The surgeon will remove a portion of your brain's hemisphere and disconnect tissues and fibers that communicate with the other side of your brain.

• Anatomic hemispherectomy: In this procedure, your surgeon will remove the frontal, parietal, temporal and occipital lobes leaving deeper brain structures like the amygdala, thalamus and basal ganglia untouched.

• Peri-insular hemispherectomy: The surgeon will disconnect specific fibers to prevent seizures from spreading in the affected part of your brain. 

• Corpus callosotomy: During this procedure, the surgeon will cut a band of fibers (called the corpus callosum) in the brain to stop seizures from spreading between the two hemispheres (sides) of the brain.