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SUNY Downstate Comprehensive Epilepsy Center

Patient Care

 

Webpage Contents

 

Facts About Epilepsy

A seizure is abnormal, repetitive, simultaneous activity of a group of connected neurons (nerve cells) that usually lasts from a few seconds to a few minutes.  A single seizure does not indicate a diagnosis of epilepsy.

Epileptic seizures may affect consciousness, movement, and sensation, resulting in a wide array of symptoms. The specific symptoms depend on the location in the brain of the nerve cells involved in the seizure activity.

The diagnosis of epilepsy is made when a person has a tendency to have unprovoked or spontaneous seizures.

For additional information please visit American Epilepsy Society website:

 

 

Procedures

EEG

An electroencephalogram (EEG) is a brain wave test that records the electrical activity of the brain.  The test is similar to the ECG (electrocardiogram) that records the electrical activity of the heart. It is used to diagnose brain disorders, especially epilepsy.

Other reasons to have an EEG would be for helping to diagnose or treat:

  • Seizure disorders
  • Head Trauma or Injury
  • Inflammation of the brain (encephalitis)
  • Stroke
  • Dementia or Altered Mental Status
  • Brain Dysfunction (encephalopathy)

    An EEG has no risks and is virtually painless. 

 

Ambulatory EEG

An electroencephalogram (EEG) is a brain wave test that records the electrical activity of the brain. An ambulatory EEG is a prolonged EEG that lasts for 1, 2 or 3 days. The ambulatory EEG allows recording brain activity during your normal activity, during overnight sleep and in your own environment.

 

Video-EEG Monitoring

This procedure is an electroencephalogram (EEG) with video and audio occurring in the hospital setting for a minimum of 24 hours.  The purpose is to be able to see what is happening when you have a seizure, spell or event and compare the video to what the EEG records simultaneously. vEEG is the standard for identification of seizures versus other events and to pinpoint brain areas where seizures may be initiating from to guide treatment, medication management and pre-surgical evaluation. There are no risks to vEEG in general.  

 

Wada Procedure / Intracarotid Amobarbital Procedure

The Wada test (named after Dr. Juhn Wada), also known as the intracarotid amobarbital procedure, is an important part of the pre-surgical evaluation in patients being considered for epilepsy surgery. It is especially important in patients with temporal lobe epilepsy. The main purposes of the Wada test are to determine if the right or left brain is dominant for language abilities, and to assess memory function on both sides of the brain. Because the test includes angiography it also provides a very accurate picture of blood vessels in the brain, which can help guide future brain surgery. The results of the test help the epilepsy team determine a surgical approach that minimizes the chances that language or memory will be affected by the epilepsy surgery.

To read more details about the WADA test, including how to prepare for the test, please visit the WADA webpage.

 

MRI

An MRI is a test that provides pictures of the inside of the body. A strong magnetic field is used to form these pictures, which is less harmful than X-rays and CAT scans. In patients with seizures, MRI images of the brain can sometimes show the cause of the seizures, such as a stroke, infection, tumor or abnormal brain tissue. By locating abnormal or damaged brain tissue, the MRI images can help pinpoint where in the brain seizures start, and surgeons may later be able to remove the damage and stop the seizures.

To read more details about MRI, including how to prepare for the procedure, please visit the MRI webpage.

 

Intracranial Monitoring

Intracranial monitoring refers to video-EEG monitoring where the EEG electrodes are placed inside the skull by a specially trained epilepsy neurosurgeon. The electrode placement is performed in the operating room with the patient asleep under general anesthesia. Typically, a series of electrodes are placed over the region or regions where seizures are thought to originate. After recovery from the surgery, the patient undergoes video-EEG monitoring in the epilepsy monitoring unit or the intensive care unit.

To read more details about intracranial monitoring, including how to prepare for the procedure, please visit the intracranial monitoring webpage.

 

Neuropsychological Testing

Information from neuropsychological testing is used for diagnosis and treatment planning. In patients who are candidates for epilepsy surgery, neuropsychological testing can help determine which areas of the brain have been affected by seizure activity.

To read more details about neuropsychological testing, including how to prepare for the procedure, please visit the neuropsychological testing webpage.

 

Epilepsy Surgery

Most people with epilepsy can live seizure-free lives by taking one or two anti-epileptic medications. Unfortunately, about 1 out of 3 people with epilepsy continues to have seizures, despite taking multiple drugs. However, there is still hope for these patients, because some can become free of seizures with another treatment: epilepsy surgery.

To read more details about epilepsy surgery, including how to prepare for the procedure, please visit the epilepsy surgery webpage.

 

 

Patient Experience

We are focused on providing a quality experience for our visitors and patients. Below are procedures that explain expectations and preparations.

 

Admission To The EMU

Your doctor may have asked you to be admitted to the SUNY Downstate Epilepsy Monitoring Unit (EMU) for a test called video-EEG monitoring (or V-EEG). As a patient in the EMU you will be cared for by an interdisciplinary epilepsy team including physicians, neuropsychologists, nurses, EEG technologists, dietitians and social workers, working together to provide excellent, comprehensive care.

To read about more information on addmission to the EMU (such as preparation, packing, and what to expect), please visit the webpage for Admission to SUNY Downstate's Epilepsy Monitoring Unit.

 

Routine EEG

During an EEG a technologist will attach electrodes ("wires") to your scalp using a special paste or other application material after carefully measuring your head for placement. The test itself is painless and safe. You will be asked to lie still during the recording. You may be asked to breathe rapidly (hyperventilate) and/or to look at flashing lights during the recording. If you feel sleepy you will be encouraged to doze during the recording. The test usually takes about 1 ½ hours. After the test is complete, the technologist will remove the electrodes and clean your scalp.

 

Ambulatory EEG (During the Ambulatory EEG)

On the day your test is scheduled, a technologist will attach electrodes ("wires") to your scalp using a glue-like substance known as collodion, after carefully measuring your head for placement. Your head will then be wrapped in gauze (like a turban) to secure the electrodes in place. The electrodes will be plugged into a special recording device which is placed in a pouch you can wear over your shoulder and take home. The test itself is painless. Wearing a button down shirt on the first day of the test, will make changing your clothes easier once the study is recording for you will not be able to shower or wash your hair until the study ends

If you feel that you are about to have a seizure, or that you had a seizure you should push the “event” button attached to the recording device. It is very important that you push the event button even if you only suspect that you had a seizure or an aura. You will also be provided with a log or diary on which you should write down both when and why you pushed the event button. This will inform the doctor reading your study that you may have had a seizure, and what occurred during it.

During your recording you can eat normal meals. Please do not chew gum or eat crunchy snacks like pretzels or chips. This will also interfere with the ambulatory EEG recording for it generates “noise” on the recording which makes interpretation of your results difficult.

 

 

Outside Resources

We provide below links to our twitter blog and outside epilepsy related websites.