Epilepsy Treatments
Our multidisciplinary team of epilepsy specialists understands the impact epilepsy has on your life and the people you love. It’s why they’re dedicated to using their expertise and the most advanced treatment to help you take control of your life.
Treatment Options to Control Seizures
An accurate epilepsy diagnosis is the first step to controlling seizures. To determine the most effective treatment to control your seizures, our specialists use the latest technology and diagnostic procedures to pinpoint the type of seizure you’re having, where it’s located and the cause.
Procedimientos de diagnóstico intracraneal
Stereotactic EEG (SEEG)
AN SEEG electrode placement procedure is performed by an epilepsy surgeon, who uses a robot to accurately target and position electrodes into the brain structures that are most likely causing seizures.
In some cases, the electrodes are left in place for about a week, sometimes longer, in order to record seizures. During this time your medication will be decreased or paused. Once a certain number of seizures are recorded, you will restart your medications and undergo electrocortical stimulation. This will replicate the recorded seizures confirming the exact location of where they are coming from in the brain.
You will be observed overnight and the electrodes will be removed before being discharged from the hospital. Your entire evaluation will be reviewed and discussed at the Epilepsy Surgery Case Conference.
Colocación de cuadrículas y tiras
La ubicación de la cuadrícula y las bandas ayuda a determinar de qué parte del cerebro provienen las convulsiones. Las rejillas son láminas o tiras de electrodos integrados en una lámina delgada y flexible de poliuretano que se implantan directamente en un área específica del cerebro para monitorear la actividad cerebral y las convulsiones. Las rejillas se utilizan para monitorear un área más específica del cerebro. Las tiras se usan para monitorear un área más amplia del cerebro.
Una vez colocados los electrodos, permanecerás en la Unidad de Monitoreo de Epilepsia (EMU), donde se supervisará la actividad cerebral y las convulsiones para determinar dónde se producen estas y qué funciones afectan. Esa información se utiliza para realizar una segunda cirugía con el fin de retirar las rejillas y la zona del cerebro que provoca las convulsiones.
Epilepsy Medication
For 70% of people with epilepsy, medication is the solution to controlling seizures. If medication isn’t effective, we offer the most advanced nonmedical and surgical therapies to control seizures.
Nonmedical treatment options to control seizures includes methods such as, diet changes, neurostimulation, resective and disconnection surgeries.
Opciones de tratamiento no médico
Dieta cetogénica
La dieta cetogénica es una dieta baja en carbohidratos, con un aporte adecuado de proteínas y alta en grasas que se utiliza para ayudar a controlar las convulsiones en niños y adultos que no han respondido al tratamiento con dos o más medicamentos anticonvulsivos. La dieta será diseñada y supervisada por nutricionistas especializados que trabajarán directamente con tu especialista en epilepsia.
Cirugías resectivas
Las cirugías resectivas consisten en extirpar la parte del cerebro que está provocando las convulsiones. Esto puede incluir áreas pequeñas (topectomías) o secciones más grandes, como un lóbulo completo (lobectomías). El tipo más común es la lobectomía temporal.
Durante una lobectomía temporal, nuestro neurocirujano extirpa parte del lóbulo temporal (la parte frontal del cerebro encargada de la memoria, el habla, las emociones y la visión) donde se originan las convulsiones.
Para mejorar los resultados, las cirugías resectivas suelen realizarse junto con una electrocorticografía, que registra la actividad cerebral antes, durante y después de la cirugía.
Laser thermocoagulation
Laser thermocoagulation is a minimally invasive surgery used to treat deep areas of the brain that cause seizures. Our epilepsy surgeon will make a small hole in the skull and use a robot with imaging guidance to direct a laser to the problem area, avoiding damage to nearby brain tissue.
It’s commonly used to treat small tumors, brain development issues or scar tissue in areas like the amygdala and hippocampus.
Cirugías de desconexión
Las cirugías de desconexión suelen indicarse para personas con áreas más extensas de tejido cerebral que provocan convulsiones (hemisferectomía) en una de las mitades del cerebro. Esta también puede ser una opción cuando las convulsiones ocurren en ambos hemisferios cerebrales al mismo tiempo o en rápida sucesión (calcosotomía).
Neurostimulation
Neurostimulation uses a device placed under the skin to send electrical pulses to the brain. These pulses can be delivered either on a regular schedule or only when a seizure happens.
Epilepsy surgeons use this treatment for patients whose seizures can’t be treated with brain surgery to remove the seizure-causing area.
Vagal Nerve Stimulator (VNS) Placement
A vagal nerve stimulator is implanted under the skin on your chest, similar to a pacemaker. A wire runs the VNS to the vagus nerve in your neck and will send regular, mild electrical impulses to your brain.
The procedure takes about 90 minutes and is done under general anesthesia as an outpatient surgery.
Responsive Neurostimulation (RNS) Therapy
Responsive neurostimulation (RNS) therapy uses two electrodes placed on or in the brain to record seizure activity. When a seizure or abnormal brain activity happens, the data is recorded by the patient or caregiver and is shared with an epilepsy specialist and engineers. They review the information and adjust the device’s settings as needed, so it can better detect and respond to seizures.
The device includes a small computer that tracks brain activity and sends electrical pulses to stop seizures as they start.
Deep Brain Stimulation (DBS) Therapy
Deep brain stimulation therapy was originally used to treat Parkinson’s Disease, movement and psychiatric disorders. It was eventually adapted to treat seizures beginning in both sides of the brain or widespread.
During DBS, electrodes are placed deep in the brain, in an area called the thalamus and on both sides. Wires from the electrodes are run under the skin to a small device implanted in the chest, which controls the stimulation that is being released.
