Epilepsy Treatment

Specialists of the neurological department at the private clinic Herzliya Medical Center conduct an effective treatment of epilepsy in Israel. The clinic uses the latest methods to diagnose neurological diseases, which determine the cause and development; following this, an individual treatment program is designed for the patient.

What is Epilepsy?

Epilepsy is a term to describe a group of neurological disorders with recurring seizures (involuntary contraction of skeletal muscles). Seizures are the result of the abnormal electrical activity of motor centers of the cerebral cortex.

Causes of Epilepsy

Epilepsy can occur spontaneously or be the result of traumatic, metabolic or toxic disturbances, and cancer. Epilepsy causes include:

• Stoke – leading cause (adults over 35 years of age)
• Brain tumor
• Trauma or injury to the brain – including prenatal injury
• Cerebral hypoxia – loss of oxygen to the brain
• Other neurological diseases – Alzheimer’s disease
• Genetic disorders
• Brain infection – meningitis, AIDS

Types of Epilepsy

Epilepsy in one form or another occurs in 1% of the population. Depending on the disease causes, epilepsy is divided into two basic forms:

• Idiopathic (primary) epilepsy. This form of the disease is usually diagnosed in childhood or adolescence. Scientists have shown a genetic predisposition to the development of this form of the disease. This form of epilepsy can only be diagnosed after meticulous examination to rule out other causes of epilepsy
• Symptomatic (secondary) epilepsy. The reason for this type of epilepsy is various pathological processes affecting motor centers of the brain. For example, cerebrovascular accident (stroke, intracerebral hemorrhage), brain tumors, severe head injury, infectious lesions (meningitis, encephalitis). Secondary epilepsy is often observed in individuals with drug and alcohol addiction and may be due to the side effects of certain medications

Epileptic seizures may be triggered by physical factors (temperature drops, flickering light), drinking alcohol, smoking, physical or psychological stress.

Symptoms and Clinical Forms of Epilepsy

Symptoms vary depending on the types of seizure; seizures are classified according to 2 groups:

1. Generalized seizures affect the whole brain. Subtypes are:

• Absence seizures – signs of staring into space or rapid blinking
• Tonic-clonic seizures – muscle spasms, loss of consciousness

2. Focal seizures (partial seizures) affect one area of the brain. Subtypes are:

• Simple focal seizures – twitching, affected senses of taste and smell
• Complex focal seizures – confusion, irresponsive
• Secondarily generalized seizures – focal seizure that develops into a generalized seizure

During a generalized seizure, several muscle groups are affected, which can lead to falls and injuries. In some cases, involuntary urination and defecation occur. Usually, after such a seizure, the patient falls asleep, after which they regain consciousness, sometimes there is short-term memory loss.

In addition, secondary epilepsy seizures are often accompanied by hypoxia (oxygen deficiency) and hypoglycemia (low blood sugar).

The frequency of seizures varies, from singular to multiple, repetitive spells. In severe cases of epilepsy, the intervals between seizures are so short that the patient cannot regain full consciousness. Patients that suffer from prolonged epileptic seizures might develop secondary psychiatric disorders (epileptic psychosis, cognitive disorders). It is important to note that immediate medical assistance should be sought if a seizure lasts longer than 5 minutes, or if the person fell during the seizure.

Furthermore, seizures can endanger the life of the patient and others – depending on severity, driving could cause car accidents. Other complications include drowning, falling, pregnancy and epilepsy that affects the emotional health of a patient. Severe forms are life-threatening: Status epilepticus involves seizures that last longer than 5 minutes, which may cause brain damage or even death. Sudden unexplained death in epilepsy (SUDEP) is also a very rare, but fatal occurrence of unknown causes.

Childhood Epilepsy

One of the most common forms of childhood epilepsy is temporal lobe epilepsy, in which the focus of pathological activity is located in the temporal lobe. Causes of temporal lobe epilepsy may be birth trauma, hypoxia, and infectious lesions in utero or in early childhood. This form may involve both localized and generalized types of seizures. Attacks of epilepsy in children are usually of short duration, which greatly complicates acquiring a timely diagnosis and early referral to a specialist. The occurrence of epilepsy in adults requires differential diagnosis is required to exclude organic pathological changes in the brain, particularly tumors, post-traumatic changes, and cerebrovascular disorders.

Diagnosis of Epilepsy at HMC

Diagnosis of epilepsy in adults and children includes a number of studies, the main ones are:

• A thorough inspection (including medical history) by a qualified neurologist
• Laboratory tests to exclude metabolic disorders that cause seizures. Also, there is often a need for a diagnostic lumbar puncture
• Computed tomography (CT) of the brain to diagnose masses (tumors), as well as the effects of traumatic brain injury
• Magnetic resonance imaging (MRI) and functional magnetic resonance imaging (fMRI)
• Isotope scanning techniques metabolic activity of the brain – positron emission tomography (PET) and single photon emission computed tomography (SPECT)
• The study of the electrical activity of the brain – electroencephalography (EEG) and video-EEG, with continuous monitoring of electrical activity in combination with video surveillance of the patient

Drug Treatment of Epilepsy

In the neurological center of Herzliya Clinic uses innovative treatments for epilepsy, allowing to achieve a complete cessation of seizures. Along with classic anticonvulsants, experts prescribe new generation epilepsy drugs, characterized by their minimal side effects, particularly in the treatment of childhood epilepsy,

Surgical Treatment of Epilepsy at HMC

In recent years, invasive treatment methods were developed for epilepsy, allowing achieving excellent results in cases when drug treatments were ineffective. Surgical intervention includes:

• Removal of the focus of pathological activity
• Anterior temporal lobectomy and removal of the medial temporal lobe hippocampus (surgical treatment of temporal lobe epilepsy)
• Multiple subpial transections (excision of the area under the pia mater if the focus of pathological activity cannot be removed)
• Callosotomy and functional hemispherectomy. Procedures that prevent the spread of electrical impulses from one hemisphere to another
• The implantation of a vagus nerve stimulator

Following a thorough examination by clinical neurologists at Herzliya Medical Center, the most effective and safe method of epilepsy treatment will be determined based strictly on the individual patient’s case.