Treatment Options
The epilepsy care team provides a variety of treatment options for patients with seizure disorders. The aim of all therapy is to control seizures and improve each patient's quality of life.
No one treatment works for all patients. Often, the team will offer patients a number of different options. Then together, physicians and patients decide which therapy offers the best chance for a successful outcome.
Anti-Seizure Drugs/Antiepileptic Drugs
Medications can't cure seizure activity, but they can help control it. A single medication or a combination of drugs that are prescribed at the correct dosage will often produce a positive effect. The team works closely with patients to modify medications they may already be taking, or to offer a new drug therapy regimen.
Some patients at Holy Cross Hospital participate in clinical trials to test medications not yet available to the general public.
Meet Epileptologist Gregory Mathews, MD, Medical Director, Epilepsy Monitoring Unit, Holy Cross Hospital
Surgical Solutions
Patients who don't respond to medication may be candidates for surgery. Epileptologists work closely with neurosurgeons to determine if surgery is an appropriate treatment alternative.
Thermal Laser Ablation is an advanced surgical treatment option for epilepsy. Holy Cross Health uses a laser interstitial thermal therapy system, called Visualase™, an MRI-guided neurosurgical procedure that allows the surgeon to monitor tissue ablation in near real-time. With the new laser treatment, a 3-millimeter incision is made in the skull and a tiny fiber-optic thread directs laser energy to the precise part of the brain responsible for the patient’s seizures. The procedure is minimally invasive, takes less than 90 minutes to perform and patients are typically discharged the day after surgery. Holy Cross Hospital is the first hospital in the Washington, D.C., metro area to offer this procedure for treating epilepsy in adults.
Temporal lobectomy is the most common surgery used to control seizures. In this procedure, neurosurgeons remove the area of the brain that produces seizures.
Split-brain surgery is a procedure used for patients in which there are multiple sources for their seizures. In this surgery, neurosurgeons cut the corpus callosum, the tissue that connects the two hemispheres of the brain. This prevents seizures from spreading to both sides of the brain and reduces the number of seizures.
Neurosurgeons will only perform surgery when there is little or no risk of damage to areas of the brain that control speech, sight, or memory.
The epilepsy care team considers surgery in patients who have:
- Documented epileptic seizures.
- Tried a number of medicines without success or have had bad reactions to medication.
- Seizures that always begin in just one part of the brain.
Neuromodulation Therapies
Deep brain stimulation (DBS) is designed to help in the management of seizures, in combination with other treatments. During this advanced brain surgery, surgeons implant electrodes in the brain that deliver controlled electrical stimulation to targeted areas to reduce the frequency of seizures.
Vagal Nerve Stimulator Implantation (VNS): Patients also may consider having a vagal nerve stimulator implant. In this procedure, the neurosurgeon implants a small device in the upper chest. The device produces vagal stimulation by sending pulses of electrical energy to the brain through the vagus nerve in the neck. This stimulation can reduce seizure activity.
Ketogenic Diet
Some patients are candidates for treatment using special dietary medical therapy with the ketogenic diet. The diet is high in fat and low in carbohydrates and can help control seizures in some people with epilepsy that don't respond to other treatments. Patients receive the diet while hospitalized. And the center's epileptologists and dieticians carefully monitor patients for any side effects.