Epilepsy/Seizures

Epilepsy affects about three million people in the United States, and doctors diagnose about 200,000 new cases each year. About 20 percent of people with epilepsy have intractable seizures, or seizures that are not controlled with medication. Indiana University Health Neuroscience gives hope to people living with epilepsy and seizure disorder—especially those with "untreatable" or difficult-to-control forms of epilepsy.

We are the only Level IV Specialized Epilepsy Center in the state. That certification means we provide state-of-the-art care that includes:

  • A multi-specialty team of board-certified epilepsy specialists.
  • The most comprehensive diagnostic testing available.
  • Advanced monitoring capabilities.
  • A broad range of treatment options.
  • Access to emerging treatment options through involvement in clinical trials.

Our epilepsy specialists are nationally recognized and are pioneering innovative treatments for seizures that do not respond to traditional treatment. With the most sophisticated diagnostic technology available, and the most current surgical and medical treatment options, IU Health Neuroscience is the #1 choice for epilepsy care and improved quality of life.

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1. Diagnosis
2. Treatment Options
 

Diagnosis

If you experience a seizure, your neurologist may recommend an EEG of the brain. For many people, this test is enough to diagnose epilepsy and plan appropriate treatment. For people whose seizures have no known cause, and for people whose seizures cannot be controlled with medication, additional testing may be required. For these more challenging cases, IU Health Neuroscience provides continuous video EEG monitoring.

Continuous video EEG monitoring measures brain-wave activity over a 24-hour period, allowing doctors to observe seizures in real time. This helps doctors determine what kind of seizure a person is having and where the seizure is occurring in the brain. Once a diagnosis is made, our epilepsy experts can plan a more individualized care plan. While other epilepsy programs offer video EEG monitoring, IU Health Neuroscience is the only program in the nation that provides continuous, real-time video EEG monitoring, with skilled physicians doing the monitoring onsite. Monitoring units are located at Indiana University Health Methodist Hospital, Indiana University Health University Hospital and Riley Hospital for Children at Indiana University Health.

Additional diagnostic services include:

  • MRI scans
  • Functional MRI scans
  • Neuropsychological testing
  • Psychiatric evaluation and management
  • PET scans
  • WADA testing, to determine which side of the brain controls speech and has better memory for better treatment planning
  • Intracranial EEG, in which electrodes are placed directly on the brain's surface to record electrical activity and generate more accurate studies than traditional EEG

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Treatment Options

For people whose seizures cannot be controlled with medication, surgery can be a safe and effective treatment option. IU Health Neuroscience provides an experienced neurosurgical team and advanced surgical procedures, including:

Lobectomy

In a lobectomy, our neurosurgeons remove a small section of the brain where seizures originate. This procedure is a very effective treatment for people with partial seizures, or seizures that are the result of abnormal activity in one area of the brain.

The American Epilepsy Society, American Academy of Neurology and the American Association of Neurological Surgeons recommend that all people with seizures that originate in the temporal lobe (the front part of the brain) and are not controlled with medication be evaluated for this surgery. Our experienced team of neurosurgeons has treated more than 400 patients with temporal lobectomies with great success.

Multiple Subpial Transection

In this surgical procedure, our neurosurgeons make tiny incisions in the section of the brain where seizures originate. Cutting the nerve fibers in this portion of the brain interrupts the electrical activity and can greatly reduce or eliminate seizures. This can be an effective treatment for people whose seizures originate in a section of the brain that cannot be removed safely.

Vagal Nerve Stimulation

In vagal nerve stimulation, our neurosurgeons implant a tiny device under the skin near the collarbone. The device sends electrical impulses to one of the central nerves, which send information to and from the brain. Vagal nerve stimulation can be an effective treatment for people who are not good candidates for lobectomy and whose seizures cannot be controlled with medication.

Deep Brain Stimulation

Deep brain stimulation (DBS) is already used to treat tremors associated with Parkinson’s disease and is being studied as an effective, alternative treatment for epilepsy. In DBS, a small device is implanted near the collarbone or in the skull and connected to a thin, electrical wire. The tip of the wire, the lead, is implanted deep within the brain and delivers electrical stimulation at preset intervals. The electrical stimulation interrupts the activity of the thalamus and can reduce seizure activity.

IU Health Neuroscience is at the forefront of epilepsy care, participating in groundbreaking studies on DBS and paving the way for new treatments for people with epilepsy.

In the SANTE clinical trial, Indiana University Health epilepsy specialists studied the use of DBS in patients with epilepsy that cannot be controlled with medication. IU Health was one of only 17 medical centers participating in the trial. Patients underwent surgery to have two electrodes implanted on both sides of the thalamus in the brain. The neurostimulator then delivered electrical stimulation to the thalamus at preset times. Participants saw their seizure activity drop by almost half.

In the NeuroPace RNS clinical trial, the neurostimulator recorded and monitored electrical stimulation in the brain so IU Health neurologists could detect patterns of seizure activity. The neurostimulator was then set to deliver electrical stimulation when the seizure pattern began, before it spreads to other sections of the brain and before symptoms appear.

Gamma Knife Radiosurgery

Gamma Knife is not a knife at all, but rather a very precise form of radiation therapy. IU Health was one of seven U.S. centers to participate in a National Institutes of Health (NIH) study to determine the effectiveness of Gamma Knife treatment for certain seizures. The clinical trial was so successful NIH is sponsoring another trial at IU Health and several other U.S. medical centers to study the further use of Gamma Knife in epilepsy treatment. The ROSE trial is currently enrolling patients at IU Health University Hospital. For more information about the ROSE trial, call 800.210.7123.

For more information about our epilepsy program, call 317.944.4974.

Learn more about epilepsy.

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Stephanie's Story

For 25 years, Stephanie's life was ruled by epilepsy. She endured an average of 16 seizures each day. And because she never knew when the next one might strike, she was unable to participate in everyday activities. She was literally held captive by her condition. That is until she became one of the first Hoosier recipients of the NeuroPace RNS System. The small, implanted device delivers mild electrical charges to the section of the brain where her seizures originate. Programmed to detect subtle changes in her brain activity, the device sends its electrical charges before the seizure can spread and before symptoms appear. Stephanie has had the device for more than five years and her seizures are down to approximately one every other day. Thanks to the advanced epilepsy care at IU Health, she is finally enjoying the activities she previously only dreamed of. 

 

Tennelle's Story

Tennelle was just four years old when she was diagnosed with epilepsy. By the time she was 9, her seizures had become so debilitating she required hospitalization. She was admitted to IU Health Methodist Hospital, where she was put into a medically induced coma and evaluated in the IU Health Neuroscience neuromonitoring facility—the only 24/7, real-time continuous neuromonitoring facility in the country. Here, doctors monitored Tennelle's brainwaves to track the frequency and type of seizure she was experiencing. This real-time data enabled doctors to make immediate medication adjustments, and determine how Tennelle responded to those changes. Once doctors found the proper medication, Tennelle's seizures were brought under control. And now the little girl is back on track at school.