What is Epilepsy?

Epilepsy is a medical condition in which a person has reoccurring seizures, often with no identifiable cause.

In most cases, the origin of epilepsy remains unknown. Sometimes epilepsy runs in families indicating a possible hereditary factor. Epilepsy has also been linked as a possible result of alcoholism, Alzheimer's disease, brain tumor, stroke, head trauma or an abnormality of brain development (“focal cortical dysplasia”).

A person is usually diagnosed with epilepsy after having two or more seizures. In order to accurately diagnose the condition, an epileptologist (a neurologist with special training in treating epilepsy) will do a complete medical evaluation and then often recommend a variety of tests including:

• Imaging Tests (CT scan, MRI, PET scan, SPECT scan): Used to both rule out other conditions that may be causing your seizures and to further explore if there are brain abnormalities like a tumor that may be triggering your epilepsy.
  
• Electroencephalogram (EEG): The standard outpatient EEG records and measures 30 minutes of your brain's electrical activity. About half of the patients with epilepsy will show the conclusive diagnostic abnormalities in a single EEG.
  
• Neuropsychological Testing and Brain Mapping: Often used as a pre-surgical evaluation, the epilepsy team has several ways to map the brain so as to better understand what parts of the brain are being affected by epilepsy, so that important functions like language or memory are not compromised during surgery.

What Happens During a Seizure?

Epilepsy causes a sudden spurt of electrical activity in the brain resulting in a seizure. The abnormal signals that the brain then sends to the entire nervous system cause unusual behaviors and sometimes convulsions or loss of consciousness.

Types of Seizures

While there are many types of seizures, epilepsy experts usually classify them into two broad categories: Partial or generalized. Partial seizures start in just one part of the brain and they can be simple, complex, or secondarily generalized. Generalized seizures affect the whole brain and can develop from a complex partial seizure. For more information on the different seizures and the symptoms, please visit the website for the epilepsy specialists at Beth Israel Medical Center.

Surgical Treatment for Epilepsy

Although many cases of epilepsy cannot be cured, we can help the patient manage their condition. For many, epilepsy is controlled by medication, but for many patients whose seizures cannot be eliminated by medication, surgical treatment offers a chance to eliminate seizures and greatly improve quality of life.

In order to be considered a candidate for surgery, a thorough pre-surgical screening is done to determine whether surgery can be done without compromising normal brain function.

For people with seizures caused by brain tumors, vascular malformations in the brain, or developmental brain abnormalities, surgery may be an option if these abnormalities can be found, mapped and identified through image tests.  

Other people can be good surgical candidates, too, not because of obvious brain malformations, but because rigorous diagnostic tests have determined that their seizures are localized to a focused area of the brain and can be surgically treated with low risk of morbidity.

When appropriate and successful, such surgeries are, in effect, a cure for epilepsy. Dr. Robert R. Goodman has over 20 years of experience devoted to the surgical treatment of epilepsy.

Read about a New Jersey teen who suffered from uncontrollable seizures and underwent brain surgery with Dr. Robert Goodman to improve his quality of life.

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