With the right diagnosis and treatment, today epilepsy is more treatable than ever before.
“Seizure freedom is no longer the exception, but the expectation,” says Deepak Madhavan, MD, epileptologist and medical director of the Nebraska Epilepsy Center at The Nebraska Medical Center. “The landscape has changed dramatically over the last 15 years due to newer medications, more advanced diagnostic tests and more precise surgical techniques. Through medications, surgery or a combination of the two, we can reduce or completely eliminate seizures in many patients.”
The Nebraska Epilepsy Center, the only comprehensive epilepsy center of its type in the region, diagnoses and treats epilepsy patients from children to adults using some of the most advanced diagnostic and treatment tools available.
One of these tools is the MEG scanner, which is available at The Nebraska Medical Center and only a few other large epilepsy centers nationally. The MEG uses magnetic fields generated by the brain’s neuronal activity to detect brain activity with greater detail and accuracy than previous testing tools. By allowing doctors to identify exactly where the brain is malfunctioning, the MEG improves the ability to diagnose and treat the disorder with the appropriate medications and provides greater surgical precision when removing the lesion becomes necessary.
While the treatment of epilepsy has seen great strides, awareness of this unpredictable and misunderstood disease has not kept pace.
Individuals who continue to experience seizures despite treatment are probably being treated with some of the older medications, which also carry a lot of chronic side effects, notes Dr. Madhavan. The type and combination of drugs prescribed for each individual depends on the specific type of epilepsy and its point of origination in the brain.
“With our experience and advanced diagnostic tools, we can evaluate these patients, do specialized testing if necessary and make sure they are taking the appropriate medications,” he says. Dr. Madhavan and partner Najib Murr, MD, are two of just three epilepsy-trained physicians in the state.
“Using the appropriate medications can make a significant difference in managing their seizures,” notes Dr. Madhavan. “Sixty to 70 percent of patients can become seizure-free on the proper medications. The remaining 35 percent will need surgery combined with medications. Approximately 10 percent of surgery patients will see significant improvement but may still experience some seizures.”
Early diagnosis and treatment is important to prevent the disease from progressing and causing long-term side effects. Untreated, recurrent seizures can cause progressive changes to the brain and can result in seizures becoming more frequent, more severe and more difficult to treat.
The Nebraska Epilepsy Center is a level four center that sees the most complicated cases in the region. The center follows approximately 3,000 patients and performs about 40 surgeries a year, which places it in the top 10 centers in the country. It is estimated that 30,000 to 35,000 people in Nebraska have epilepsy.