Epilepsy & Seizures

Epilepsy Diagnosis

If you experience a seizure, your neurologist may recommend a brain test known as an electroencephalography (EEG). For many people, this test can diagnose epilepsy. The EEG also helps experts plan appropriate treatment.

Medical specialists from neurology and neurosurgery may also use MEG or magnetoencephalography as a test to find the source of seizures to plan for epilepsy surgery. MEG is a noninvasive test that scans, records, and evaluates brain activity by measuring the brain’s magnetic fields.

Sometimes seizures have no known cause. In some cases you cannot control them with medication. In these cases, physicians may need more testing. For these cases, the IU Health Neuroscience Center provides continuous video EEG monitoring.

Continuous Video EEG Monitoring

Continuous video EEG monitoring measures brain-wave activity over a 24-hour period. This allows your physicians to observe your seizures in real time. This helps them determine what kind of seizures you have. They also see where the seizures occur in your brain.

Once your physician makes a diagnosis, he or she can develop a care plan for you. Monitoring units are located at IU Health Methodist Hospital and Riley Hospital for Children at IU Health.

Diagnostic services also include:

• Magnetic resonance imaging (MRI) scans
• Functional MRI scans
• Neuropsychological testing
• Psychiatric evaluation and management
• Positron emission tomography (PET) scans
• Intracranial electroencephalography (EEG). In this test, electrodes are placed directly on the brain’s surface to record electrical activity. This generates more accurate studies than traditional EEG

Epilepsy Treatment

Our nationally-recognized epilepsy specialists pioneer innovative treatments for seizures. This includes seizure types that have not responded to normal treatment.

The IU Health Neuroscience Center offers advanced diagnostic technology. We also have the latest medical and surgical treatment options. We have the only Level IV Specialized Epilepsy Center in the state. This certification means the Neuroscience Center provides advanced care that includes:

• A team of board certified epileptologists. These are neurologists who specialize in the treatment of epilepsy, and neurosurgeons
• The most complete diagnostic testing available
• Advanced monitoring capabilities
• A broad range of treatment options
• Access to emerging treatment options through clinical trials

If you cannot control your seizures with medication, surgery may be a safe and effective treatment option. We provide an experienced neurosurgical team and advanced surgical procedures. Our procedures include:

Lobectomy & Multiple Subpial Transection

Lobectomy

Our neurosurgeons remove a small section of the brain where seizures originate. This procedure can help you if you have single focus seizures—seizures resulting from abnormal activity in one area of the brain.

You should receive an evaluation for this surgery when seizures come from your temporal lobe (the front part of the brain) and medicine does not help. Our team of neurosurgeons has successfully treated more than 400 patients with temporal lobectomies.

Multiple Subpial Transection 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 electrical activity and can reduce or eliminate seizures. This can treat your seizures if they originate in a section of the brain that surgeons cannot remove safely.

Vagal Nerve Stimulation

In vagal nerve stimulation, our neurosurgeons place a tiny device under the skin near the collarbone. The device sends electrical impulses to one of the central nerves. These nerves send information to and from the brain. Vagal nerve stimulation may treat you if you cannot receive a lobectomy and medications do not help.

Deep Brain Stimulation

Deep brain stimulation (DBS) treats tremors associated with Parkinson’s disease. Researchers are studying it as an alternative treatment for epilepsy. In DBS, a small device is placed near the collarbone or in the skull. This connects to a thin, electrical wire. Surgeons place the tip of the wire, the lead, deep within the brain. This delivers electrical stimulation at set intervals. The electrical stimulation interrupts the activity of the thalamus. This can reduce seizure activity.

Gamma Knife Radiosurgery

Gamma Knife surgery is a precise form of radiation therapy. IU Health was one of seven U.S. centers to participate in a National Institutes of Health (NIH) study on Gamma Knife radiosurgery. The study helped determine how effective this treatment was for certain seizures.

Resources

Clinical Trials

The IU Health Neuroscience Center leads the way in epilepsy care, and participates in groundbreaking clinical trial studies, paving the way for new treatments for people with epilepsy. Past trials that have proven successful include:

• The SANTE clinical trial at Indiana University Health involved epilepsy specialists who studied the use of DBS in patients with epilepsy who could not control it with medicine. IU Health was one of only 17 medical centers participating in the trial. Participants saw their seizure activity drop by almost half.
• The NeuroPace RNS clinical trial where the neurostimulator recorded and monitored electrical stimulation in the brain so IU Health neurologists could detect patterns of seizure activity.

Learn more about epilepsy at the following national websites.

• NIH Institute of Neurological Disorders and Stroke: This website provides the latest research related to epilepsy and seizures.
• Medline Plus: This website provided by the US National Library of Medicine has information about epilepsy and resources to help those suffering from it.