How are seizures diagnosed?
The Epilepsy Center uses advanced diagnostics for patients with new-onset seizures, or patients unable to manage their epilepsy. Patients can expect:
- A complete medical history and physical exam
- Discussions with the patient’s family or other observers who witnessed the seizures
- Determination of which medications have been most effective or caused unacceptable side effects
- Advanced testing based on the patient’s medical history and needs
How is epilepsy treated?
Treatment begins with a comprehensive and personalized evaluation by a board-certified neurologist who specializes in epilepsy and seizures.
Some patients with epilepsy will experience relief from their seizures after trying only one or two medications. Others will have a form of epilepsy that is more difficult to treat.
Medication-resistant epilepsy is also known as intractable epilepsy or refractory epilepsy. A patient has medication-resistant epilepsy when he or she continues to have seizures after trying at least two different antiepileptic medications, taken alone or in combination. About 30 percent of people with epilepsy have the medication-resistant kind.
About one third of patients with medication-resistant epilepsy are candidates for epilepsy surgery. They can undergo surgery safely and seizures usually reduce significantly or in many cases, completely stop. Before surgery, patients will undergo extensive testing to locate the source of their seizures. This helps ensure that surgery will not impact their speech, mobility or quality of life.
Click to expand a topic and learn more about the specific diagnostic and treatment services at the UC Epilepsy Center are below:
If you have recently experienced a seizure or seizure-like episode, you can visit our New-Onset Seizure Clinic. We will provide rapid consultation within a week of referral.
This special clinic is for patients who have experienced a recent seizure or seizure-like episode. Led by David Ficker, MD, the clinic is designed for quick access to specialists who focus solely on epilepsy. These specialists make timely referrals to an Epilepsy Monitoring Unit (EMU) for comprehensive evaluations, including evaluations for epilepsy surgery.
Delays in accurate diagnosis and appropriate treatment can mean years of seizures resulting in memory deficits, loss of the ability to work and drive, and loss of self-esteem. Studies show that most epilepsy patients wait too long before seeing the experts at an epilepsy center.
The New-Onset Seizure Clinic is located at the UC Health Physicians Office located in Clifton and at UC Health Physicians Office North located in West Chester.
Call (513) 475-8730 to request an appointment.
The Epilepsy Monitoring Unit is the only 24-hour inpatient monitoring unit in the region. In fact, our EMU has been at the forefront of advanced epilepsy evaluation for 30 years. The video recording/EEG equipment is highly specialized and is not available at most hospitals.
A traditional EEG lasts about 30 minutes. It gives us a “snapshot” of the brain’s activity during that particular recording period. A short EEG may not be enough to gather the information needed to treat your seizures adequately. Inpatient video EEG monitoring allows us to precisely map where a seizure starts and where it spreads in your brain. Plus, through careful analysis of the video, the epilepsy team can see how a person behaves and what happens during a seizure. This information helps guide the team to recommend a treatment that will best control the seizures with the fewest side effects. The EMU allows us to see a more comprehensive picture of your brain activity.
Call (513) 475-8730 to request an appointment.
The UC Epilepsy Center uses a variety of tools to pinpoint your seizures and determine the proper treatments. They are:
- Electroencephalogram (EEG): The most popular test to diagnose seizures, the EEG measures electrical brain activity. Electrodes placed on the scalp measure brain activity.
- Magnetic Resonance Imaging (MRI): An MRI is a noninvasive diagnostic test that provides a detailed view of the brain. MRI images can identify structural brain abnormalities that may be the cause of a patient’s epilepsy.
- Functional Magnetic Resonance Imaging (fMRI): Images from fMRI help physicians determine the location of brain abnormalities in relation to areas of the brain that are responsible for speech, memory and movement.
- Positron Emission Tomography (PET): After injecting a dye with special tracers, doctors can assess brain metabolism that helps pinpoint the location of the seizure focus.
- Ictal SPECT: When a patient is in the epilepsy monitoring unit, a special tracer is injected at the start of a seizure. A brain scan done later will show the region where the seizure started. This can only be done in the EMU with highly trained technologists closely monitoring a patient so seizures can be detected immediately.
As a patient at the UC Epilepsy Center, you do not receive care from only one epilepsy specialist – but 13. That’s because we created an Epilepsy Conference – a weekly meeting with all our epilepsy specialists present to combine expertise and reach an optimum treatment plan with each complex case. We review:
- How the seizures started
- Causes that are known or suspected
- Current and past treatments
- All brain imaging
- EMU video and EEG monitoring
Then the team makes a treatment plan together. The plan is specific for each patient.
The value of bringing together so many experts cannot be overestimated. In several instances, the team recommended treatments that truly changed the patient’s outcome – even if he or she had been told there were no other medical or surgical options available. These patients clearly benefited from the combined expertise of many specialists, rather than having their treatment hinge on a single radiologist’s report or an individual neurologists or neurosurgeon’s decision, made in isolation.
Once a patient has been diagnosed and a treatment plan has begun, the UC Gardner Neuroscience Institute provides exceptional follow-up care to patients with epilepsy and to their families.
Call (513) 475-8730 to request an appointment.
Some patients have not responded to standard anti-seizure treatments and are not candidates for surgery. New therapies, including medications, medical devices and surgical procedures, are evaluated in research studies known as clinical trials. The UC Epilepsy Center has a 30-year history as a world leader in developing new treatments for epilepsy. Often these new therapies are investigational, which means they are not yet approved by the U.S. Food and Drug Administration for general use. Participation in clinical trials offers the potential for new treatment options and allows patients to participate with researchers in driving the discovery of effective therapies for epilepsy.