Epilepsy and Seizure Center
If you have seizures or epilepsy, the Comprehensive Epilepsy Center of Dayton at Premier Health provides advanced diagnosis and care to help improve your quality of life as you learn to manage your condition.
Located at Miami Valley Hospital, the Comprehensive Epilepsy Center of Dayton is part of the Wright State University and Premier Health Neuroscience Institute. We treat all types of epilepsy and seizure disorders, including seizures that do not respond to medicine. Our team includes fellowship-trained and board-certified epilepsy specialists who diagnose and treat patients in new ways, including:
- Subspecialty clinic for epilepsy
- Access to investigational medicines, sometimes through clinical trials
- An advanced epilepsy monitoring unit with 24-hour intensive monitoring and computer-assisted video EEG
- Specialty epilepsy surgery when medicines cannot control seizures
When you come to the Comprehensive Epilepsy Center for care, we listen to your concerns and talk with you about your treatment goals to create a care plan that fits your lifestyle.
What Is Epilepsy?
Epilepsy affects the brain and causes specific types of seizures:
- Focal (partial) seizures. These seizures are localized in the brain. Types of focal seizures include:
- Simple partial seizures. These occur while the patient is fully aware.
- Complex partial seizures. These cause confusion or possibly loss of awareness
- Secondary generalized seizures. These spread to involve jerking.
- Generalized seizures. There are several types of generalized seizures. They affect the whole brain. Some examples of generalized seizures include:
Many people with epilepsy experience more than one seizure type.
There are different types of epilepsy. The type of epilepsy is determined by evaluating the types of seizures that the individual patient has and using testing to determine the cause, the response to treatment, and other factors.
What causes epilepsy is unknown. Often, a cause isn’t found. Testing is done to try and determine a specific cause. Epilepsy may be linked to brain injury or infection, stroke or other lesions, or lack of oxygen during birth.
Other genetic conditions, such as Down Syndrome, neurologic diseases or sometimes Alzheimer’s disease can be involved.
Diagnosing Epilepsy
It’s important to get the right diagnosis, as other medical conditions also have seizure-like symptoms. To make an epilepsy diagnosis, your doctor will talk with you about the frequency of your seizures and the kind of seizures you have. Your doctor will also:
- Talk with you about your medical history
- Perform a physical exam
- Complete a neurological exam
Several tests are used to diagnose or confirm epilepsy. Your doctor may use the following tests to check brain function and see what’s happening inside your brain:
- EEG (electroencephalogram). An EEG measures and records the brain's electrical activity. The test can show abnormalities that suggest a specific type of epilepsy and can guide treatment recommendations. An EEG takes about 40 minutes and involves pasting small wires on the head.
- Video EEG monitoring. Performed at the epilepsy monitoring unit at Miami Valley Hospital, this specialized test monitors your brain activity and takes video recordings for several days. The information helps your doctor analyze your seizures and understand what happens before, during and after a seizure. The information can also help determine where the seizures begin in the brain.
- MRI (magnetic resonance imaging). Magnets and radio waves create detailed images of the brain that may show structural problems that can give rise to seizures. The images may also help define treatment options.
- Functional MRI (fMRI). MRI images show which parts of the brain are involved in specific activities, such as motor, language, visual or even memory functions.
- CT (computed tomography). X-rays and computer technology combine to form a picture of the brain.
- PET/CT (positron emission tomography). Images are created using a radioactive agent to show changes in brain tissue.
- SPECT (single photon emission computerized tomography). This imaging test shows blood flow in the brain and can help find where seizures begin.
- Neuropsychological testing. This is performed at the specialized Premier Health Brain Mapping Center.
A neuropsychologist will ask you questions and have you perform certain activities and testing to determine which areas of the brain are involved in cognitive, language, memory and motor skills, and to pinpoint changes from seizures
in focal brain areas. This testing can also show which brain areas might be at risk from surgery.
Our specialized neurophysiology laboratory provides inpatient and outpatient diagnostic services as a key part of our epilepsy program, including:
- Video EEG monitoring in the epilepsy monitoring unit
- Adult inpatient and outpatient EEG
- Evoked potentials testing for adults
Your epilepsy team will use all of your test results to create a personalized treatment plan.
Epilepsy Treatments
There is no cure for epilepsy, but there are a number of mostly non-invasive treatment options that can help you manage your condition and lead an active, healthy life.
Treatment options include medicine, nutrition, and surgery. Your epilepsy team will work with you to provide comprehensive care and assessment to find the care that is best for your specific condition.
Treatments may include:
- Medicines. There are many medicines used to reduce seizures from epilepsy, and most people can control their seizures with medicine alone. It takes time to find the medicine or combination of medications that works best for you. In some cases, your doctor may try more than one medication to determine your best option. Once you find medicines that work, your doctor will monitor you on a regular basis to make sure your medicines do not damage liver or bone marrow function and to check how your body breaks down the medicine.
- EMU (epilepsy monitoring unit). If you do not respond to anti-seizure medicines or your seizures are difficult to control, your doctor may recommend inpatient video EEG monitoring in the EMU at Miami Valley Hospital. Information from the EMU helps your doctor understand your seizures. Monitors digitally track the brain’s electrical activity, heart rate, and blood-oxygen saturation levels around the clock. Using infrared video cameras, EEG recordings, and other equipment, information is collected before, during and after seizures.
- Ketogenic diet. Eating a diet high in fat and low in carbohydrates and calories may help to control seizures. This diet is often used when seizures do not respond to medicine.
- Epilepsy surgery. Before any epilepsy procedure, you undergo a thorough evaluation for epilepsy surgery. This helps your doctor decide which surgery is best for you. We perform a range of epilepsy surgeries to help reduce or stop seizures. Surgery is used when medicines and diet do not
help. These procedures involve removing or ablating (damaging) the area of the brain where seizures begin to block the seizure’s electrical spread. They include:
- Laser ablation. This procedure damages the area where seizures were found to begin to try to prevent the seizure or the spread of the discharges.
- Focal resection. The part of the brain where seizures begin is removed.
- Temporal lobectomy. This is the most common focal resection surgery. When seizures begin in the temporal lobe, removal of all or part of the temporal lobe can reduce or stop the seizures.
- Hemispherectomy. A rare procedure where one hemisphere or half of the brain’s cerebrum is removed or disconnected.
- Corpus callosotomy. This is a rare procedure generally performed only in children. The corpus callosum, which connects the two hemispheres of the brain, is cut to prevent the spread of seizures.
- Visualase®MRI-guided Laser Ablation. This minimally invasive procedure allows the neurosurgeon to successfully target and ablate specific areas within the brain without the risks that come with open surgery.
- Vagus nerve stimulator (VNS). This implanted device helps to control and reduce seizures. Similar to a pacemaker, the device is placed under the collarbone. A wire from the device is attached to the vagus nerve in the neck. The VNS delivers regulated electrical signals to the brain through the vagus nerve, reducing the number and intensity of seizures.
- Clinical trials and research. As a Premier Health patient, you have access to the most advanced treatments through our participation in epilepsy research. If you qualify, you may be able to try new medicines or other treatment therapies
by taking part in a clinical trial.
Other specialized services include:
- Brain mapping. If you need surgery, our advanced Brain Mapping Center helps doctors understand which parts of the brain are causing seizures. Brain mapping also lets neurosurgeons create highly personalized surgical plans and ensures precision during neurosurgery.
- ROSA™ Brain. This minimally
invasive robotic surgical assistant enhances the safety and reliability of procedures such as the surgical evaluation of epilepsy. ROSA’s planning software creates a 3-D scan of the patient’s brain and maps out the exact pathways needed
for specific procedures. This procedure is used for some types of procedures. If you are a candidate for surgery, your neurosurgeon will consider this and other devices and techniques in planning surgery for you.
Your Epilepsy Team
The Premier Health epilepsy care team brings extensive training and experience to help you understand and manage your epilepsy or seizure disorder. We work with many other doctors to ensure you receive personalized, compassionate care.
Our specialized epilepsy team includes:
- Epileptologists (neurologists who specialize in epilepsy)
- Neurosurgeons specializing in functional and epilepsy surgery
- Neuropsychologist specializing in epilepsy
- Advanced practice nurse epilepsy program coordinator
- Epilepsy nurses
- EEG technologists
- Neuroradiologists specializing in evaluation brain imaging
- Interventional neurologists
- Neurocritical care neurologists
Contact Us
Our specialists are ready to help you get back to the things that matter most in your life. Find a provider near you or consult our list of related practices.
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