Epilepsy is a condition of the nervous system that causes recurring seizures.  It affects about one percent of all Americans or approximately three million people. More than 200,000 new cases are diagnosed every year.

If you have a seizure, this does not necessarily mean that you have epilepsy. If you have multiple seizures; however, you should get evaluated by an epilepsy specialist (or epileptologist).

Interesting Fact: Only three percent of people with epilepsy have seizures triggered by exposure to flashing lights at certain intensities or to certain visual patterns.

From initial evaluation to long-term continued care, each patient will experience the care and management that only a highly specialized epilepsy center can provide. Using a multidisciplinary team approach, the team's medical and surgical teams actively conduct research and education in their respective disciplines. We have at our disposal the most advanced and modern tools for the diagnosis and treatment of epilepsy and the underlying cause for the seizures.

Tests

The epileptologists at UHealth’s Department of Neurology International Comprehensive Epilepsy Center (ICEC) are trained specifically in the detection and treatment of epilepsy. By using the latest diagnostic technology, they will be able to tell the difference between an epileptic seizure and one that is caused by another condition.

Doctor Evaluation
During an exam a neurologist may ask you about any headaches or other pain occurring in or near the brain and cognitive problems, such as an ability to concentrate or recall certain facts.

They will likely ask you questions specifically about your seizures, including:

• Is there something that could have provoked the seizure or event, like sleep deprivation, alcohol or drug abuse, or anything else?
• Where were you and what was going on when the seizure started?
• Did it happen right after you stood up?
• Was there a warning, like an unusual feeling before the seizure started?
• Exactly what happened during the seizure?
• How long did it last?
• Were you tired or confused after the seizure?
• Have you had more than one seizure? If so, were they all alike?

Electroencephalogram (EEG)
A procedure that records the brain's continuous, electrical activity by means of electrodes attached to the scalp. This may tell the doctor if you have had a seizure recently and what kind of seizure it was.

Lumbar puncture (spinal tap)
During this procedure a special needle is placed into the area around the spinal cord in your lower back. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain and spinal cord.

Treatments

Our physician experts use lasers to surgically target the part of the brain where seizures originate, in order to control the activity. These procedures are less invasive and the recovery from the surgery is faster.

Medication
A doctor may prescribe medication based on the type of epileptic seizure and syndrome, on the age and gender of the patient, on the existence of other medical, cognitive and psychiatric disorders and on whether other medication is used for the treatment of these conditions.  Approximately 60 to 70 percent of patients will become seizure-free with antiepileptic drugs (AEDs).

Surgery
Unfortunately, 30 to 40 percent of patients will continue to have seizures despite the use of AEDs. In such cases, your physician will discuss what surgical options may be best for you.  If you are considered to be a good candidate for surgery, there is a 50 to 70 percent chance of being cured.

Implantable Computer Chip
Another promising advancement is a computer chip that is programmed to detect abnormal brain activity that precedes a seizure and responds with brief electrical stimulation that disrupts the activity and normalizes brainwaves often before seizure symptoms begin.

Vagus Nerve Stimulation
VNS attempts to control seizures by sending small pulses of energy to the brain from the vagus nerve, which is a large nerve in the neck. This is done by surgically placing a small battery into the chest wall. Small wires are then attached to the battery and placed under the skin and around the vagus nerve. The battery is then programmed to send energy impulses every few minutes to the brain. When the person feels a seizure coming on, he/she may activate the impulses by holding a small magnet over the battery. In many cases, this will help to stop the seizure.

Deep Brain Stimulation
Deep Brain Stimulation (DBS) sends electronic signals to the brain, which may lessen the severity and frequency of seizures. It involves placing a pacemaker-like device under the skin in your chest (not in the brain). Very thin wires connect the device to your brain to enable the signals to reach the source of your symptoms.

Why Choose UHealth?

Level IV epilepsy center. As one of the National Association of Epilepsy Center’s designated level IV epilepsy centers, we offer you the highest level of diagnostic abilities and treatment options to eliminate your seizures.  Our multidisciplinary specialists include epileptologists, neuropsychologists and other professionals work together to make sure you receive comprehensive care.

The expertise of specialized centers. Did you know that 30 percent of people who are sent to specialized centers for difficult seizures find out they were misdiagnosed?  An inaccurate epilepsy diagnosis could mean years of costly and unnecessary medications. The expert physicians at our state-of-the-art International Comprehensive Epilepsy Center (ICEC) provide you with a comprehensive medical evaluation, so you get the right diagnosis and the right treatment the first time you are evaluated.

Advanced and personalized seizure control.  No two epilepsy patients are the same – the type, severity and frequency of your seizures are different as are your triggers. Our team uses the latest diagnostic imaging to gather detailed information about your epilepsy, so we effectively get your seizures under control.

Access to new research and treatments. Since the ICEC is connected to a large research university, we are constantly learning about newer or different treatments that may help you.

An on-call epileptologist. A faculty member is available 24-7 to respond to our patient’s emergencies and to provide telephone consultation to referring and outside physicians.

EEG video monitoring. There are 4-bed EEG monitoring units in both the adult neurology and on the pediatric floor. In these units, patients are monitored for extended periods of time (1) as part of a pre-surgical evaluation for epilepsy surgery and (2) to establish the diagnosis in patients with episodes of loss of consciousness or with unusual behavior.

Outpatient clinics. A large number of patients receive specialized care and treatment in the Epilepsy Outpatient Clinics. The faculty is experienced in classification of the epilepsies, selection of the appropriate medical therapy and adjusting the therapies for optimal outcome. The outpatient clinics are a great resource for the community where the faculty can provide second opinions for referring physicians.

Active surgical program. For over 30 years, experts at the epilepsy center have been treating individuals with medically refractory epilepsy. We have been active in the development of new techniques sub-pial transaction for epilepsies in critical area of the brain. The specialists at ICEC were involved in the first evaluation of vagal nerve stimulation for the treatment of epilepsy. We continue to work to develop new approaches in the surgical treatment of epilepsy.

A neurophysiological laboratory. Convenience. Besides routine electroencephalogram, the neurophysiology laboratory at ICEC has the ability to record outpatient ambulatory EEG recordings and all day EEG/Video recordings.

Neuro-imaging.A broad range of neuro-imaging is present on the University of Miami Miller School of Medicine campus. High magnet strength MRI imaging is available using specially constructed techniques which provides both structural and functional images. PET and SPECT imaging is available on both an outpatient and inpatient basis.