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  • Epilepsy

    Having epilepsy can be scary — seizures often occur for no reason and without warning. It can be difficult to find out why a person has the condition. The doctors at Mount Sinai West are here to help put you at ease, and find the best possible epilepsy treatment for you.

    Understanding Epilepsy

    Epilepsy is a medical condition in which a person has reoccurring seizures, often with no identifiable cause.

    Diagnosis of Epilepsy

    In most cases, the origin of epilepsy remains unknown. Sometimes epilepsy runs in families, indicating a possible hereditary factor. Epilepsy has also been linked as a possible result of alcoholism, Alzheimer's disease, brain tumor, stroke, head trauma, or an abnormality of brain development (“focal cortical dysplasia”).A person is usually diagnosed with epilepsy after having had two or more seizures. In order to accurately diagnose the condition, an epileptologist (a neurologist with special training in treating epilepsy) will do a complete medical evaluation, and will then often recommend a variety of tests, including:

    • Imaging Tests (CT scan, MRI, PET scan, SPECT scan): Used to both rule out other conditions that may be causing your seizures, and to further explore if there are brain abnormalities, like a tumor, that may be triggering your epilepsy.
    • Electroencephalogram (EEG): The standard outpatient EEG records and measures 30 minutes of your brain's electrical activity. About half of patients with epilepsy will show the conclusive diagnostic abnormalities in a single EEG.
    • Neuropsychological Testing and Brain Mapping: Often used as a pre-surgical evaluation, the epilepsy team has several ways to map the brain so as to better understand what parts of the brain are being affected by epilepsy, so important functions like language or memory are not compromised during surgery.

    What Happens During an Epileptic Seizure?

    Epilepsy causes a sudden spurt of electrical activity in the brain, which results in a seizure. The abnormal signals that the brain sends to the entire nervous system cause unusual behaviors, and sometimes convulsions or loss of consciousness.

    Types of Seizures

    While there are many types of seizures, epilepsy experts usually classify them into two broad categories: Partial or generalized. Partial seizures start in just one part of the brain, and can be simple, complex, or secondarily generalized. Generalized seizures affect the whole brain, and can develop from a complex partial seizure. For more information on the different seizures and their symptoms, please visit the website of the epilepsy specialists at Mount Sinai Beth Israel.

    Surgical Treatment for Epilepsy

    Some cases of epilepsy are not well managed with medication, but the neurosurgeons at Mount Sinai West in New York City can help many of those patients better manage, or cure their condition with epilepsy surgery. Epilepsy surgery offers patients a chance to eliminate seizures and greatly improve quality of life, often without further need for medication and its side effects.

    In order to be considered a candidate for epilepsy surgery, a thorough pre-surgical screening is done to determine whether surgery can be performed without compromising normal brain function. In addition, the source of the epileptic seizures must be “mapped” by monitoring electrical activity with placement of electrodes in the brain (stereoelectroencephalography, or SEEG), before epilepsy surgery can occur. Once the seizure source is located, and the patient is at low risk for surgery, epilepsy surgery can be performed, and when successful, can be in effect, a cure for epilepsy.

    The Department of Neurosurgery at Mount Sinai West now offers ROSA™, a state-of-the-art robotic surgical assistive device used for accurately mapping the source of epileptic seizures, and for surgical removal of the tissue causing the seizure. ROSA offers epilepsy surgery patients a much less invasive mapping procedure, and an unprecedented level of safety for epilepsy surgery. Learn more about ROSA for epilepsy surgery.

    For people with seizures caused by brain tumors, vascular malformations in the brain, or developmental brain abnormalities, brain surgery may be an option if these abnormalities can be found, mapped, and identified through image tests.


    Meet our Epilepsy Surgery Experts

    Photo of Saadi Ghatan, MDSaadi Ghatan, MD
    Chair of Neurosurgery at Mount Sinai West and Mount Sinai St. Luke’s
    Director, Pediatric Neurosurgery at Mount Sinai Health System
     
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