Perhaps you or someone you know has experienced a seizure. A seizure is an episode that may include convulsions, confusion, behavioral changes, zoning out, automatic bodily movements, and/or being disoriented after waking from sleep. Sometimes people are unaware that they have had a seizure even after it is over. However, they may also be conscious but unresponsive during a seizure.
When a person has more than one seizure that are said to be “unprovoked,” they are considered to have epilepsy. An unprovoked seizure wasn’t caused by another medical condition such as having low blood sugar or detoxifying from drugs or alcohol.
Instead, epilepsy seizures are related to a misfiring of brain cells that aren’t communicating with each other correctly. The abnormal electrical activity and hyper-excited neurons create chaos. Depending on where this chaos is located in the brain, seizure symptoms will look different. Sometimes a seizure results in speech problems; other times the issue may be smell or involuntary movement. Epilepsy is a very common condition – 1 in 26 people will be diagnosed with it at some point in their lives.
“Living with epilepsy can feel overwhelming for patients and their families and caregivers,” says Hind Kettani, MD, a neurologist and epileptologist board certified in both neurology and epilepsy. Her main focus is treating epilepsy at the AdventHealth Neuroscience Institute Tampa. Dr. Kettani has extensive experience in managing refractory epilepsy as well as epilepsy in people who have cognitive delays or other disabilities. “Our mission is to help patients with epilepsy and their families face the unexpected with confidence by providing pioneering treatments, supportive care and continuous education that empowers them,” she continues.
Today, comprehensive epilepsy centers like the one at the AdventHealth Neuroscience Institute Tampa have the advanced tools needed to diagnose the root cause of seizures and to offer leading-edge treatments to provide the highest quality of care for those with epilepsy and their families.
Diagnosing Epilepsy in Tampa
While epilepsy can be diagnosed in people at any age, it is more common before age 10 or after age 60. Epilepsy can be a secondary effect of stroke, infection, head trauma and brain lesions such as tumors. However, in most cases, the cause of epilepsy remains unknown.
The epileptologists at AdventHealth Tampa use advanced tools to diagnose epilepsy. After gathering a medical history, reviewing symptoms and collecting testimony from family members who can describe the seizure, Dr. Kettani and her colleagues perform a thorough neurological exam. Then they investigate seizures with a test called an EEG (electroencephalography) that records brain wave activity.
“Our dedicated, well-trained EEG technicians play a major role in performing a high- quality EEG,” says Dr. Kettani. “They exhibit the utmost expertise and compassion.”
Premier Epilepsy Monitoring Unit in Tampa
However, the routine EEG used in the outpatient clinic results in diagnosis for only about half those with epilepsy. Therefore, many patients will need a short stay on the Epilepsy Monitoring Unit (EMU). The first in the Tampa Bay area, AdventHealth Tampa’s EMU allows clinicians to collect a good amount of data on brain wave activity, using video EEG monitoring that operates with sophisticated software. The resulting long-term video EEG helps doctors pinpoint the location of the brain tissue where the seizures are focused as well as the type of seizure.
Data from the EEG helps guide the most appropriate treatment for a patient. Some patients will also need an MRI or another advanced imaging test. These tests are used to check for brain lesions or abnormal tissue. If a patient’s seizures are brought on by a brain tumor, then surgery to remove it may result in complete treatment.
Treatments for Epilepsy
Epilepsy treatments have come a long way in the last few years. Often the first course of treatment is antiseizure medications, which help about 7 out of 10 patients with epilepsy live seizure-free.
“We’re very fortunate to have this many treatment options in the 21st century,” says Dr. Kettani. She points out that there are now more than 20 prescription medication options to prevent seizures, with 15 of them having been approved since 1993 and more than three becoming available only within the past year.
Even so, it takes an expert team to ensure that patients with epilepsy are taking the right medication.
“Managing antiseizure medication is very delicate,” Dr. Kettani says. “Each drug comes with its own benefits and risks. Also, side effects and dosing schedules vary from drug to drug.” The goal of treatment is to establish control of and freedom from seizures. However even after control has been achieved, people may still have an occasional breakthrough seizure.
For about 3 in 10 patients, management of their seizures requires more than medicine alone. These people have other treatment options that, while more invasive, often provide the freedom from seizures they need. A neuropsychologist and neurosurgeon often join Dr. Kettani in caring for these patients.
“When the team comes together, the success rate is very high,” she says. There are options less invasive than brain surgery. These include neuromodulator devices that function similarly to the way pacemakers do for the heart. These devices regulate the electrical impulses when they detect an abnormal brain activity. These devices may be less invasive, open loop devices such as the vagus nerve stimulator that sends impulses to the entire brain. Other devices are slightly more invasive and require electrodes to be implanted in the brain. However, these closed loop devices stimulate the brain in specific locations. These devices include responsive nerve stimulation (RNS) and the more recently FDA-approved deep brain stimulation (DBS).
Brain surgery may be recommended if a patient has a safely removable area of the brain responsible for seizures. However, if this area is inoperable, patients may benefit from MRI-guided laser or radiofrequency (RFA) ablation that shrinks the tumor. Other patients may be well-served by stereotactic radiosurgery, a form of radiation therapy that non-surgically “cuts out” a brain tumor.
“We are committed to offering our patients a better quality of life,” stresses Dr. Kettani. “We aim toward a life free of seizures by exploring the newest and most advanced therapies to stop them.”
Compassionate Epilepsy Care in Tampa
Dr. Kettani was drawn to practice at AdventHealth Tampa because of its advanced facilities for epilepsy care; she quickly realized that the center delivered unusually attentive care as well.
“Compassionate care is very important with epilepsy patients,” she says, noting that this can be missing from larger centers. In addition, AdventHealth Tampa offers support group meetings for parents of children with epilepsy and partners with Epilepsy Florida to provide other services that make life living with epilepsy much easier.
If you are looking for seizure-related diagnosis or treatment, contact the seizure and epilepsy program at AdventHealth Tampa. For more information, call