Seizures & Epilepsy
seizures and Epilepsy
The Center for Brain and Neuro Care will provide expert, comprehensive, and individually tailored treatment plans for all patients, even those with the most difficult-to-control seizures. These plans are designed to enable each patient to live a full and productive life.
What is a Seizure?
A seizure is a sudden electrical discharge in the brain, causing changes in behavior, sensation, or consciousness.
What is the difference between epilepsy and seizures?
A seizure is a single occurrence
Epilepsy is two or more unprovoked seizures
Seizures are classified as:
+ Generalized seizures, which involve both sides of the brain
+ Partial seizures, which begin in one location of the brain
Types of Seizures
Seizures are divided into two major groups, depending on where they begin in the brain.
Generalized seizures – These seizures seem to begin everywhere in the brain at once. Types of generalized seizures include:
+ Absence seizures
+ Myoclonic seizures
+ Clonic seizures
+ Tonic seizures
+ Tonic-clonic seizures
+ Atonic seizures (drop attacks)
+ Partial seizures – Also called “focal” seizures, partial seizures begin in one location of the brain.
What is an aura?
An aura is a sensation of unusual symptoms that occurs before a seizure. An aura may include
+ visual changes such as bright lights, zigzag lines, slowly spreading spots, distortion of shape or size of objects, and blind or dark spots in the field of vision
+ hearing voices or sounds (auditory hallucinations)
+ strange smells (olfactory hallucinations)
+ feelings of numbness or tingling in one side of the body or face
+ feeling separated from your body, sometimes called déjà vu or its opposite, jamais vu
+ anxiety or fear
+ nausea
+ postictal state, the aftereffect of the seizure, for example, arm numbness, loss of consciousness, partial paralysis, and confusion.
Symptoms & Causes of Multiple Sclerosis (MS)
Symptoms and Causes of Multiple Sclerosis
Symptoms vary greatly from person to person, over time, and in intensity.
They can include:
+ Bladder problems (frequent urination, urgency)
+ Depression
+ Dizziness or vertigo
+ Fatigue
+ Impaired coordination (ataxia)
+ Sensory symptoms (numbness, pain)
+ Spasticity (muscle stiffness or spasms)
+ Temperature sensitivity – worsening of MS symptoms by heat
+ Tremors
+ Trouble with short-term memory and concentration
+ Visual symptoms (optic neuritis, association with pain and eye movement, double vision)
+ Weakness
Causes of Multiple Sclerosis (MS)
The exact cause of MS is unknown. It appears to be an autoimmune disease in which the immune system is stimulated to attack myelin in the central nervous system.
MS can be triggered by viral infections, low vitamin D, the environment, and genetic predisposition. People with family members diagnosed with MS and other autoimmune diseases are at a slightly higher risk.
Diagnosing Seizures and Epilepsy
Getting an accurate history of the event
It can be difficult to diagnose a seizure. Because physicians are rarely able to witness a seizure during a clinic visit, it is vital to have a seizure witnessed by family, bystanders, or emergency services personnel. They can report symptoms like eyes rolling up, tongue biting, frothing at the mouth, urinary incontinence, loss of consciousness, muscle tremors or muscles stiffening.
Tests done to diagnose seizures or epilepsy
We offer complete neurological consultation for epilepsy and related conditions. We provide neurophysiological tests, including routine EEGs and outpatient and inpatient video-EEG monitoring. Many (but not all) people with seizures or epilepsy have abnormal EEGs.
We also offer other tests for seizures and epilepsy, including:
+ Long-term inpatient video-EEG monitoring with scalp or intracranial electrodes
+ Neuropsychology
+ Speech and auditory processing evaluations
+ Magnetic Resonance Imaging (MRI)
+ Positron Emissions Tomography (PET)
+ Single photon emission CT
+ Magnetic Resonance Spectroscopy (MRS)
+ NeuroPsych Testing
+ Wada test/angiography
+ Intracranial monitoring
+ Depth electrodes
+ Subdural strips
+ Subdural grids
Treatment Seizures and Epilepsy
There are many options for treating seizures and epilepsy. Our individually tailored treatment plans include a combination of the following:
+ Medication
+ Vagus nerve stimulation (VNS)
+ Dietary therapy
Some patients do not respond to the medication for their seizures. They are called medical refractory patients, and we will refer them to Johns Hopkins Hospital or the University of Maryland for surgery.