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Diagnosing Epilepsy

Epilepsy is a brain disorder that causes recurrent, unprovoked seizures. A seizure occurs when abnormal electrical activity affects the brain. The abnormal electrical activity during epileptic seizures can cause a wide variety of symptoms, ranging from mild movements or sensations that the patient can remember later, to severe generalized seizures with stiffening, shaking, prolonged confusion and loss of memory.

Seizures vary in severity and duration, but typically last from a few seconds to a few minutes. Often, seizures are associated with alterations in perception and memory. If left uncontrolled, seizures are very disruptive to everyday life, interfering with a person’s ability to work, travel and live independently.

More than 3 million Americans are affected by epilepsy and other seizure disorders. According to the Epilepsy Foundation, epilepsy is the third most common neurological disorder in the U.S., behind Alzheimer’s disease and stroke.

Diagnosis and Evaluation for Epilepsy

The Comprehensive Epilepsy Center at Barnes-Jewish Hospital specializes in the diagnosis and treatment of adults with epilepsy. The Joint Commission has certified Barnes-Jewish as an Epilepsy Center of Excellence--one of the first three in the nation to receive this recognition. Our team of epilepsy specialists--including neurologists, neurosurgeons, neuropsychologists and epilepsy nurses--offer a depth of expertise not found in other centers in the region.

Epilepsy actually includes several types of seizure disorders. For the most effective treatment, it is important to uncover the specific type of epilepsy or seizure disorder each patient is experiencing. Our diagnostic expertise allows us to differentiate among the different types of epilepsy, including:

  • Temporal lobe epilepsy (TLE)
  • Neocortical epilepsy
  • Juvenile myoclonic epilepsy
  • Lennox-Gastaut syndrome
  • Symptomatic epilepsy (brought on by tumor, injury or previous stroke)
  • Absence epilepsy (more common in children than adults)

Patients seen at the Comprehensive Epilepsy Center include those who:

  • Have experienced a first seizure
  • Question the diagnosis or cause of their seizures 
  • Are newly diagnosed with seizures
  • Have seizures that haven’t responded to conventional anti-epileptic medications
  • Are interested in participating in research using investigational anti-epileptic medications if conventional anti-epileptic medicaitons have been ineffective
  • Have seizures that are controlled, but are experiencing adverse effects from anti-epileptic medication
  • Want a second opinion, or need additional education and counseling regarding epilepsy
  • Are women with epilepsy who have concerns regarding their care including contraception and/or pregnancy

Some important tools for diagnosing and evaluating response to treatment are EEG (electroencephalography) and brain imaging. Another important tool, continuous video EEG, combines video monitoring with EEG data, providing a wealth of information to neurologists as they plan the most appropriate treatment for each patient. Video EEG can take several days to complete and is done in the specially-equipped epilepsy monitoring unit (EMU) at Barnes-Jewish Hospital.

Treating Epilepsy

Our goal is the best control of seizures so that our patients may reach their full potential. Services include education, medical management and surgical treatment for seizures.

Of all neurological disorders, epilepsy remains one of the most treatable. When seizures don’t respond to medication or other treatments, the Comprehensive Epilepsy Center offers hope. Often, patients who were diagnosed elsewhere come to us for re-evaluation. Our advanced neurodiagnostic testing allows us to reach a more accurate diagnosis, leading to more focused and effective treatment recommendations.

Treatment options include clinical trials of new anti-epileptic medications, which offer a chance at seizure control when other anti-epileptic medications are ineffective. Epilepsy surgery also is a good treatment option for many patients. When seizures begin in a localized area of the brain and medication and other treatments have failed, epilepsy surgery can result in complete control of seizures.

Our center has vast experience in treatment of epileptic seizures with surgery, as Washington University was one of the first medical centers in the United States to use brain surgery on a regular basis to successfully treat patients with seizure disorders not controlled with medications.

To make an appointment with a Washington University epileptologist, neurologist or neurosurgeon at Barnes-Jewish Hospital, call 855.925.0631.

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