By ALLISON WENDORF, Tufts Medical Center Staff
One in 26. That’s how many people living in the United States, according to the Epilepsy Foundation and the CDC, will develop epilepsy at some point in their lifetime. There are over 150,000 new cases of epilepsy each year, three million people in the U.S. and over 65 million worldwide with this condition.
Neurologists, epileptologists, scientists and researchers have been studying the causes of and best treatments for epilepsy for decades. And although approximately one-third of people with epilepsy are unable to control their seizures with current treatment methods, there have been a number of advances in recent years that have given epilepsy specialists an arsenal of weapons to treat the condition.
“Medication is typically the first tool that we use in treating epilepsy, which is diagnosed after a person experiences two or more unprovoked seizures that have been separated by at least 24 hours,” said Tufts Medical Center epilepsy specialist, Joel Oster, MD. “At Tufts MC, we stay up-to-date with the latest trends, including precision medicine, offer clinical trials and truly tailor medication management for each individual patient. For example, if you’re a young woman with epilepsy who is trying to start a family, our approach for medication management is going to be very different than for a 55-year-old male, who has had controlled epilepsy for years.”
For some, epilepsy cannot be controlled by seizure medications. Called “refractory” or “drug-resistant” epilepsy, this condition is typically diagnosed when a person is unable to stay seizure free with trials of at least two seizure medications. Comprehensive epilepsy centers, like the Level 4 comprehensive epilepsy center at Tufts Medical Center, offer a number of alternative treatment options for these patients.
“If medications aren’t working to control seizures and a patient is diagnosed with refractory epilepsy, we conduct a complex evaluation of their triggers, cognitive function, brain anatomy and their own personal goals. We do this with a full team of specialists, including their primary care physician, epilepsy specialist, the neurosurgery team, neuropsychology, social services and other specialties as needed. By putting the patient and their goals at the center of our team, we can determine the best treatment approach and work with the patient so that they feel fully empowered in managing their condition,” said Dr. Oster.
Treatment options for refractory epilepsy include surgery to remove the seizure-producing areas of the brain, vagus nerve stimulation and a more recent approach called responsive neuro stimulation (RNS).
Tufts MC offers the Neuropace RNS system, which consists of a small, battery-powered device called a neurostimulator that is surgically implanted in the skull by neurosurgeon, James Kryzanski, MD. The neurostimulator is connected to tiny wires that are placed on one to two areas of the brain that have been determined by the team to be triggering the person’s seizures.
“The Neuropace device allows us to record the person’s brain activity in key areas and collect data on seizure activity and treatment progress over the long term,” explains Dr. Kryznaski. “After we’ve collected enough data, we can program the device to detect abnormal activity in the brain and deliver a stimulation to interrupt that activity and prevent oncoming seizures.”
No matter which treatment approach you decide, the goal of comprehensive epilepsy centers like the one at Tufts MC is to provide patients living with epilepsy the tools they need to better understand their condition, cope with the effects it can have on daily life and ultimately, to live life without seizures or side effects.
The above content is provided for educational purposes by Tufts Medical Center. It is free for educational use. For information about your own health, contact your physician.
Posted March 2017