Evaluation and Diagnostic Service
When standard medications alone cannot control epilepsy, a variety of medical and surgical treatment options may be presented after a comprehensive evaluation is completed. Patient evaluations are tailored to meet the specific needs of each individual and typically include one or a combination of these diagnostic procedures:
- Prolonged Video/Electroencephalogram (EEG): Provides information for diagnosis and classification of the different types of seizures and epilepsies.
- Magnetic Resonance Imaging (MRI): High resolution MRI is used to find structural evidence of the seizure focus; spectroscopic MRI studies help locate brain dysfunction.
- Positron Emission Tomography (PET): In collaboration with the Division of Nuclear Medicine, metabolic studies locate areas of the brain that are not functioning normally.
- Single Photon Emission Computerized Tomography (SPECT): When indicated, a SPECT scan is performed at the onset of a seizure for the purpose of locating the area that generates the seizures and is compared with a SPECT scan when the brain is not seizing. This comparison assists our neurologists in localizing the abnormal brain areas.
- Neuropsychological Evaluation: Standardized assessment of memory and cognition is done to identify any changes in thinking skills that may relate to epilepsy, and assist with diagnosis and treatment planning.
The Surgical Evaluation
In some candidates, the scalp EEG is not sufficient to localize the seizures, and further evaluation with intracranial electrodes may be needed.
Intracranial electrodes are very fine wires placed surgically in regions suspected to include the seizure focus to record the brain's electrical activity and allow functional brain mapping to be performed.