More than 60% of patients’ seizures can be well controlled and managed
with antiepileptic medications. Hoag’s specialists consider each
patient’s disease and lifestyle in determining which medications
to prescribe. And since many antiepileptic medications have side effects
and drug interactions, Hoag specialists work closely with patients and
their primary care physician to continually manage drug therapy.
Treatment options include:
- Anticonvulsant Medications
- Epilepsy Surgery
- Vagus Nerve Stimulation (VNS) Therapy
- Responsive Neurostimulation (RNS) Therapy
- Dietary Therapy
In approximately one third of patients, anticonvulsant medications cannot
adequately control seizures. When seizures cannot be controlled with medication
alone, Hoag offers the latest techniques in surgical intervention. Surgery
can eliminate seizures in the majority of patients, and reduce seizures
in most of the remainder. To locate the exact location of the brain causing
seizures, Hoag neurosurgeons utilize state-of-the-art neuronavigational
technology and sophisticated magnetic resonance imaging techniques to
precisely reach and treat the seizure areas safely.
For non-surgical candidates and for patients whose seizures are resistant
to antiepileptic medications, Hoag specialists also perform vagus nerve
stimulation (VNS) surgery. Implanted under the skin below the left collarbone,
the VNS generator delivers intermittent nerve stimulation to the vagus
nerve to effectively block seizures from occurring in a good percentage
Epilepsy surgery began as the removal of structural abnormalities in the
brain. With the addition of EEG data from preoperative and intraoperative
recordings, areas of removal expanded to include tissue that was grossly
normal in appearance but known to give rise to epileptiform activity.
If the information obtained during the pre-surgical evaluation consistently
points towards a single area of the brain as being the site of seizure
onset, then the patient may have surgery for resection of that area.
In the majority of patients with epilepsy, seizures can be well controlled
with appropriate medication. However, current estimates indicate that
20 - 30% of patients with epilepsy are refractory to all forms of medical
therapy. These medically intractable patients are candidates for surgical
treatment in an attempt to achieve better seizure control.
Another group of patients who might benefit are those whose seizures may
be relatively well controlled but who have certain characteristic presentations
or lesions that strongly suggest surgical intervention might be curative.
Some patients may benefit from a form of dietary therapy known to potentially
control the occurrence of seizures. The modified Atkins diet, or MAD diet,
is a variation on the traditional ketogenic diet, which requires patients
to virtually eliminate carbohydrates from their daily intake. Patients
are limited to 10-20 carbs per day.
Studies show that the MAD diet can greatly decrease, and in some cases
eliminate, the occurrence of seizures in epileptic patients. Talk to your
doctor to determine whether dietary therapy could benefit you.