Epilepsy: Disrupting the Rhythms of Your Brain

There are currently about 50 million people worldwide living with epilepsy. Although it was first recognized as a brain disorder more than 2,000 years ago, effective treatments weren't developed until the last century. Thanks to leading-edge technology and a commitment to whole-person care, we now have treatment options to help those living with epilepsy reclaim their lives.

Keep reading to learn from our board-certified neurologist specializing in epilepsy, Ronald Fields, MD, MS, more about epilepsy, including its causes, diagnosis and treatment options.

Understanding Epilepsy

Our brains work by sending electrical signals between nerve cells to control how we think, feel, move and respond to the world around us. But for those with epilepsy, these signals don’t always fire in an organized way. Instead, they may fire all at once or much faster than normal. This sudden burst of electrical activity causes symptoms, usually in the form of seizures.

“The word epilepsy means that a person has a brain circuit that makes them prone to seizures," said Dr. Fields. A seizure is a surge of electrical activity lasting several seconds to minutes within a region of brain circuitry that temporarily causes the brain circuits to malfunction.

Diagnosing Epilepsy

"The diagnosis of epilepsy is often based on the patient providing a history of having more than one unprovoked seizure,” said Dr. Fields. To confirm the diagnosis and rule out other conditions, your provider may order:

• A neurological exam
• Blood tests
• Brainwave test (Electroencephalogram or EEG)

“We also like to get a detailed picture of the brain with an MRI. This is done to look for larger miswirings that could suggest an increased risk for seizures,” said Dr. Fields. Even if the test results are normal, your doctor may still diagnose epilepsy based on seizure history and symptoms. This is because seizures are highly unpredictable and difficult to diagnose. When someone has a seizure, it often won’t happen in an environment where it can be properly assessed and managed. Doctors must rely on both a patient’s history and detailed diagnostic imaging to properly diagnose epilepsy.

Epilepsy Treatment Options

The most common treatments for epilepsy are medications, surgical procedures and seizure devices. “Anti-seizure medications (ASMs) are used to help block discharges from a seizure circuit and can be thought of as a chemical fire blanket. Roughly two out of three patients with epilepsy will be able to control their seizures with one or more anti-seizure medications,” said Dr. Fields.

Specific low sugar (carbohydrate) diets have also been shown to help decrease seizures for adults with epilepsy, usually in combination with anti-seizure medications. “The diets are strict and require close supervision from a medical provider and often a dietitian. Because diets can be difficult to maintain, they're usually reserved for select patients with drug-resistant epilepsy,” explains Dr. Fields.

Unfortunately, anti-seizure medications are not entirely effective for 1 in 3 epilepsy patients who are drug-resistant. For many of these patients, surgery may be the best option. In some cases, the seizure circuit in the brain can be surgically removed. More often, neurostimulation devices can be surgically implanted to disrupt the abnormal neural signals that cause epilepsy.

“The three FDA-approved brain pacemaker-like devices include responsive neurostimulation (RNS), deep brain stimulation (DBS) and vagus nerve stimulation (VNS) therapies,” said Dr. Fields.

Although neurostimulation devices don’t cure the underlying tendency for seizures, many patients can experience a significant decrease in their seizure frequency, and some may stop having seizures. That decrease can make a huge difference in their quality of life.

“Scientific research is being done on several fronts to better understand how seizure-prone brain circuits form, and how electrical discharges transition to longer electrical seizures. This knowledge can help identify new chemical and electrical targets for the development of epilepsy treatments,” shares Dr. Fields.

Face Epilepsy With Confidence

Whether you’re experiencing signs of epilepsy or were recently diagnosed, our team of expert neurologists is here to help you face it with confidence. Find expert neurology care close to home from our team of trusted neurologists in Kansas City.