A low-dose radioactive material is injected into a vein to provide a view of active areas in the brain and help identify abnormalities.

This magnetic scan provides a very detailed picture of the brain’s structure with special protocols for epilepsy patients.

This special type of MRI details neurological activity to help define areas of the brain involved in language and other functions.

A magnetic scan detects the brain’s electrical activity and helps identify where seizures originate in the brain.

Electrical activity of brain is recorded with the use of electrodes attached to the scalp to determine the area of the brain where seizures begin.

Similar to an EEG, this form of brain mapping also involves surgery to implant electrodes into the skull. The goal is to identify parts of the brain that perform vital functions as well as parts of the brain that might be most involved in generating seizures.

Some epilepsy patients have difficulty controlling their seizures with medications. When this happens, a patient is asked to stay in the hospital so episodes can be recorded with video and EEG monitoring. This includes monitoring language and memory and behavioral testing during episodes. It enables the health care team to identify where episodes originate and can be extremely helpful for planning future therapy. 

During monitoring, some patients find their diagnosis changes or becomes more specific. Some can stop taking medicines for epilepsy and be referred for other treatments and some can change epilepsy medications to ones that are more effective, or learn that they are candidates for surgical treatment.

Patients being monitored as described above may also undergo single-photon emission computed tomography (SPECT). During this procedure, a technician injects low-dose radioactive material into a vein to provide a 3-D map of blood flow activity in the brain at the onset of a seizure.

The first and most common treatment for epilepsy is typically seizure medications. If the patient does not respond well to one medication, another may be tried until the right type is found. Medication proves successful in controlling epileptic seizures in roughly 70 percent of patients.

There are more than 20 medications to treat seizures, and the use of these medicines is dictated by such factors as where the seizures originate, frequency of seizures and the patient’s age. 

Dietitian-monitored therapy is a method of controlling seizures and is typically used in combination with seizure medication. Dietary treatment includes the high-fat, low-carbohydrate ketogenic diet or a modified Adkins diet. Traditionally used only in treating young epilepsy patients, these diets are now being recommended for patients of all ages.

For epilepsy patients whose seizures cannot be controlled with medications, surgery may be indicated. There are two categories of surgical procedures: diagnostic and therapeutic. Diagnostic procedures include stereoelectroencephalography (SEEG) and grid implantation. 

Therapeutic surgery includes resection, in which the area of the brain where seizures originate is removed; modulation, in which devices — vagus nerve stimulation (VNS), responsive neurostimulation (RNS) and deep brain stimulation (DBS) — are implanted to deliver electrical impulses to the brain to stop seizures; and disconnection, a procedure that involves disconnecting the area of the brain where seizures originate to prevent them from spreading.