Neurosciences

Epilepsy is a disorder of the brain that causes seizures and can affect people in different ways. Seizures can be mild and barely noticeable, such as staring spells or twitches to the extremities, while others may be violent and harmful to the individual. Since epilepsy and seizures can occur in many different ways in many different people, diagnosing and treating the disorder is often challenging to patients and physicians.

The causes of epilepsy are just as challenging and can be caused by different conditions that affect a person’s brain. Often the cause is unknown, but some conditions that lead to epilepsy are stroke, brain tumor, traumatic brain injuries, head injury, and central nervous system infection. Seizures are the main sign of epilepsy and typically a person is diagnosed with epilepsy when they have had two or more seizures.

Did You Know?

1. Seizures seen in epilepsy are caused by disturbances in the brain’s electrical activity.
2. Epilepsy is usually diagnosed after a person has had two seizures that were not caused by some known medical condition. Epilepsy is not contagious, is not a mental illness and is not a developmental disability.
3. More than half the time, the cause of epilepsy is unknown. When a cause is found, it is often due to head injury, infection of the brain, stroke, brain tumor, Alzheimer’s disease, malformation of an area of the brain, and genetic factors.
4. Epilepsy is usually diagnosed with a medical history, neurological examination, blood work, electroencephalograph (EEG), CT, MRI or PET scans of brain.
5. Epilepsy is treated with anti-seizure medications. At times, depending on the type of seizure, surgery, Vagus Nerve Stimulation (VNS), responsive neurostimulation (RNS) and dietary therapies like ketogenic diets may be used.

Focal seizures are located in just one area of the brain. These seizures are also called partial seizures.

• Simple focal seizures affect a small part of the brain. These seizures can cause twitching or a change in sensation, such as a strange taste or smell.
• Complex focal seizures can make a person with epilepsy confused or dazed. The person will be unable to respond to questions or direction for up to a few minutes.
• Secondary generalized seizures begin in one part of the brain but then spread to both sides of the brain. In other words, the person first has a focal seizure, followed by a generalized seizure.

Seizures may last as long as a few minutes.

Do I call 911?

Seizures do not usually require emergency medical attention. Only call 911 if one or more of these are true:

First aid for any type of seizure

There are many types of seizures. Most seizures end in a few minutes.

These are general steps to help someone who is having any type of seizure:

• Stay with the person until the seizure ends and he or she is fully awake. After it ends, help the person sit in a safe place. Once they are alert and able to communicate, tell them what happened in very simple terms.
• Comfort the person and speak calmly
• Check to see if the person is wearing a medical bracelet or other emergency information
• Keep yourself and other people calm
• Offer to arrange transportation to ensure the person gets home safely

---

Stop! Do NOT...

Knowing what NOT to do is important for keeping a person safe during or after a seizure. Never do any of the following:

• Do not hold the person down or try to stop his or her movements
• Do not put anything in the person’s mouth. This can injure teeth or the jaw. A person having a seizure cannot swallow his or her tongue
• Do not try to give mouth-to-mouth breaths (like CPR). People usually start breathing again on their own after a seizure
• Do not offer the person water or food until he or she is fully alert

A person who has a seizure for the first time should talk to a health care provider, such as a doctor or nurse practitioner. The provider will ask the person what happened, and look for the cause of the seizure. Many people who have seizures take tests such as brain scans for a closer look at what is going on. The most important step is to speak with your provider.

There are many things a provider and a person with epilepsy can do to stop or lessen seizures. The most common treatments for epilepsy are:

• Medicine. Anti-seizure drugs are medicines that limit the spread of seizures in the brain. A health care provider will change the amount of the medicine or prescribe a new drug if needed to find the best treatment plan. Medicines work for about 2 in 3 people with epilepsy.
• Surgery. When seizures come from a single area of the brain (focal seizures), surgery to remove that area may stop future seizures or make them easier to control with medicine. Epilepsy surgery is mostly used when the seizure focus is located in the temporal lobe of the brain.
• Other treatments. When medicines do not work and surgery is not possible, other treatments can help. These include vagus nerve stimulation, where an electrical device is placed, or implanted, under the skin on the upper chest to send signals to a large nerve in the neck.

Sometimes we can prevent epilepsy. These are some of the most common ways to reduce your risk of developing epilepsy:

• Have a healthy pregnancy. Some problems during pregnancy and childbirth may lead to epilepsy. Follow a prenatal care plan with your health care provider to keep you and your baby healthy.
• Prevent brain injuries.
• Lower the chances of stroke and heart disease.
• Be up-to-date on your vaccinations.
• Wash your hands and prepare food safely to prevent infections

Vagus Nerve Stimulation (VNS) Therapy

UTMB provides services such as noninvasive evaluations and the vagus nerve stimulation (VNS) implantation procedure. Surgeons who specialize in the treatment of cranial nerve disorders, spinal surgery, peripheral nerve surgery, minimally invasive surgery, neurotrauma and neurovascular surgery, perform VNS Therapy® as a day surgery procedure. The procedure is designed to prevent seizures by sending regular, mild pulses of energy to the brain via the vagus nerve.

UTMB’s dedicated Epilepsy Monitoring Unit (EMU) was designed to evaluate, diagnose and treat patients who experience hard-to-treat epileptic seizures.

Under the leadership and expertise of EMU Director, Dr. Todd Masel, the highly specialized 4-bed unit offers continuous overnight video, microphone and electroencephalography (EEG) monitoring to identify the specific region of the brain in which each patient’s seizures originate.

The multidisciplinary care team (which consists of physicians, nurses, technicians, therapists and other health care workers) is then able to devise the appropriate care plan to reduce or eliminate the episodes, as well as provide long-term medical management treatments.

UTMB’s highly qualified EEG team also offers 24/7 EEG monitoring for UTMB’s inpatients. This is particularly useful in the Neurosciences Critical Care Unit, which cares for patients who are critically ill with neurological disorders.

Questions about Epilepsy Monitoring

As part of your evaluation at our EMU, we'll record your typical events for better diagnosis and/or to adjust your antiepileptic medication safely. To record your events, we use a video camera, microphones and continuous EEG recording. We do these so your doctor can learn more about your seizures and provide the best possible care for you.

Click each question below to expand/collapse for more details: