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A. What are seizures and epilepsy? The brain is made up of billions of nerve cells that normally communicate with each other through electrical and chemical signals; therefore allowing us to think, see, move and feel. However, sometimes abnormal electrical or chemical communications between a group of nerve cells occur; this group of nerve cells then communicate with a network of other nerve cells having a domino effect that results in an epileptic seizure. During an epileptic seizure, these erratic signals travel through the nervous system, affecting behavior, level of awareness and consciousness, movement, perception or sensation. Epilepsy is a disorder marked by the tendency to have recurrent, unprovoked seizures. Anyone who has had two or more unprovoked epileptic seizure has epilepsy. During one’s lifetime the chance of developing is epilepsy approaches 4%. However, not all people who have seizures have epilepsy. Some people have a single epileptic seizure and never develop epilepsy. In fact, if you live to age 80, there is a one in ten chance that you will have a single epileptic seizure.
For an animated version describing seizures and how the brain works?, please visit the following site: http://www.epilepsy.com/web/animation.php?swf=what_is
View the "What is a Seizure" animation in PDF format: http://www.epilepsy.com/pdfs/what_is_a_seizure.pdf
B. What are the symptoms of seizures and epilepsy? The most easily recognized seizure type is a generalized tonic clonic seizure (convulsion). However, seizures can take a variety of forms, such as a feeling of fear, a rising sensation in the stomach, a brief stare, a lapse of memory, or a loss of muscle tone. Most seizures last from a few seconds to a few minutes. If a seizure lasts longer than five minutes, the person should be brought to the hospital. C. How common is epilepsy? More than 2.5 million people in the Epilepsy is not a rare condition and affects people of all ages and races. In fact, it is one of the oldest conditions of the human race, with references to the disorder dating back to 5000 B.C. Throughout history, some of the most famous figures were suspected or known to have had epilepsy. The list includes: Socrates, St. Paul, Alexander the Great, Julius Caesar, Dante, Joan of Arc, Sir Isaac Newton, Napoleon Bonaparte, George Frederick Handel, Ludwig van Beethoven, Charles Dickens, Vincent Van Gogh, and Alfred Nobel. Although there is no evidence that having seizures or epilepsy can result in exceptional abilities, this impressive list demonstrates that epilepsy does not necessarily limit the potential for achievement. D. What causes epilepsy and how is it diagnosed? There are many possible causes of epilepsy, including: severe head injury, stroke, brain tumor, an abnormal collection of blood vessels in the brain, birth trauma, brain infection, or malformed regions of the brain. The Comprehensive Epilepsy Program utilizes the most advanced diagnostic technology to classify and determine the cause of the seizure or epilepsy. Bayfront offers: · Digital, long-term, video-EEG monitoring and a dedicated in-hospital unit for around-the-clock evaluation. · Epilepsy protocol high-resolution MRI (magnetic resonance imaging) · 24-hour ambulatory EEG monitoring · PET scan (positron emission tomography) · Subtraction Ictal SPECT (single photon emission computed tomography) · Magnetic Source Imaging (through the · Magnetic Resonance Spectroscopy E. Treatment options Medical intervention or drug therapy is successful in approximately 70 percent of people with epilepsy. In the last decade, several new anti-epileptic medications have been developed, giving persons with epilepsy more treatment options with fewer side effects. Bayfront’s epilepsy team instructs patients on how to use these new medications and how to improve their effectiveness. Bayfront also offers patients the opportunity to participate in investigational drug trials of new epilepsy medications, giving them the advantage to be among the first to benefit from advancements in the field. Surgical intervention is considered after two seizure medications fail to control a patient’s epilepsy (this condition is known as intractable epilepsy). According to a study in the New England Journal of Medicine, the success rate for becoming seizure-free with new medications is only five to 10 percent, when other medications have failed. Approximately 30-35 percent of patients with intractable epilepsy do not become seizure-free with medications, and are at greater risk for reduced quality of life, injury, or sudden unexplained death. Epilepsy surgery is a highly effective, safe and accepted method of treatment for patients with refractory epilepsy. The New England Journal of Medicine reported that epilepsy surgery is more effective than medications in making intractable temporal lobe epilepsy patients seizure-free. In well-selected candidates, approximately 70-80 percent of patients can become seizure-free or have their seizures significantly reduced. As a Level IV epilepsy center, Bayfront is one of only a few hospitals nationwide that is qualified to offer epilepsy surgery. A comprehensive evaluation will determine if epilepsy surgery is an option. Vagal nerve stimulation is a treatment option for patients who are not candidates for epilepsy surgery. A small device, similar to a pacemaker, is implanted and electrically stimulates the left vagus nerve in the neck. The device operates automatically to help prevent seizures, but the patient can also activate the device on their own if they feel a seizure coming on.
F. What is an Epilepsy Specialist (Epileptologist): An epilepsy specialist typically has an additional six years of training after medical school. This training includes an internship in internal medicine, a three year residency in neurology and a two years of dedicated epilepsy training at an academic medical center with a comprehensive epilepsy program. G. When looking for an epilepsy specialist, you should ask the following questions: 1) Is your doctor board certified in Neurology? You can check the website of the American Board of Medical Specialties. http://www.abms.org/login.asp 2) Is your epilepsy doctor board certified in clinical neurophysiology and epilepsy? To determine whether a physician is board certified by the American Board of Clinical Neurophysiology, contact
3) Are the EEG technologists at the facility registered with the American Board of Registered EEG technologists? Technologists who are certified by the ABRET take an intensive written examination. After passing this exam, they sit for an intensive oral examination. You can determine EEG technologist certification at this website: http://www.abret.org/ 4) Is your epilepsy doctor part of a comprehensive level IV epilepsy program? A comprehensive epilepsy program consists of a multi-disciplinary team of experience professionals including a neurologist specializing in epilepsy, an epilepsy neurosurgeon, an epilepsy clinical nurse specialist, a neuropsychologist, a neuroradiologist, registered EEG technologists with experience and training in video-EEG monitoring. For a copy of the NAEC guidelines, please follow this link: http://www.naecepilepsy.org/guidelines/guidelines.html
Most comprehensive epilepsy programs are members of the National Association of Epilepsy Centers (NAEC) http://www.naecepilepsy.org/centers/centers.html Bayfront’s epilepsy program meets and exceeds the NAEC guidelines for a level IV epilepsy program (the only one in
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