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Epilepsy and Seizure Center

Miami Valley Hospital’sComprehensive, Level 3Off Site Icon, Epilepsy Center provides advanced diagnosis and management for patients with epilepsy. 

The Comprehensive Epilepsy Center’s fellowship-trained and board-certified epilepsy specialists are able to diagnose patients with seizures in ways not previously possible. The advanced epilepsy monitoring unit offers 24-hour intensive monitoring with computer-assisted video EEG (electroencephalogram), provided by trained EEG technologists. 

The Comprehensive Epilepsy Center provides patients access to advanced diagnostic procedures and conventional epilepsy medications, while also providing access to investigational medications (drugs not yet available from the pharmacy). When seizures cannot be controlled with medications alone, our comprehensive epilepsy team has surgeons who have many years of experience surgically treating epilepsy. Miami Valley Hospital offers minimally invasive robotic technology ROSA™ Brain for neurological procedures including surgical evaluation of epilepsy.

An Accurate Diagnosis

Because a number of unrelated medical conditions also have seizure-like symptoms, the correct diagnosis is critical. At Miami Valley Hospital’s Epilepsy Center, we have the sophisticated resources to make an accurate diagnosis.

We start by taking a complete medical history and performing a neurological exam. Testing is an important part of the diagnostic process. Tests your doctor might order may include:

Our fellowship-trained, board-certified team of epileptologists and our electroencephalograph (EEG) technologists use advanced tools and technology to monitor your health 24 hours a day, seven days a week. 

Each case is reviewed carefully to develop individual treatment plans.

Epilepsy Monitoring Unit

When a patient’s diagnosis is unclear, or if a patient does not respond to anti-seizure medications, video electroencephalogram (video EEG) monitoring can assist physicians in making an accurate diagnosis. The Epilepsy Center has an inpatient epilepsy monitoring unit located within the Neuro Intensive Care Unit. These spacious rooms are equipped with monitors that digitally track the electrical activity of the brain, heart rate and blood-oxygen saturation levels around the clock.

Using infrared videocameras, EEG recordings and other equipment, we collect essential information to help understand what happens before, during and after seizures. Our team always uses the utmost caution to ensure patient privacy. Monitoring is performed with a privacy-protected, closed-loop video monitoring system viewed only by trained physicians and technicians. Monitoring sessions can last several days. In some cases, special imaging studies, called SPECT and PET scans, are done to provide information about the function of different brain areas during and between seizures. Learn more about Video EEG in the Epilepsy Monitoring Unit

Medical Treatment for Epilepsy

Medication is the foundation of epilepsy treatment. There are many medication choices available to treat epilepsy. It takes time to determine which medication or combination of medications works best to control seizures with the fewest side effects. In some cases, your doctor may try more than one medication to determine what works best for you. 

The length of time you must continue using your medication is hard to predict. It is not unusual for patients to stay on medications for two years or longer. 

Most people with epilepsy can achieve seizure control with medicines alone. When you and your doctor find a medication that works for you, you will need periodic follow-up. Even if you are seizure-free and feeling well on your medications, your doctor may recommend intermittent lab work or other exams, including:

Liver function tests/complete blood count: Specific blood tests to determine whether your medications are interfering with liver or bone marrow function. If they are, your doctor can recommend other treatment options. This affects a relatively small number of patients.

Anti-seizure drug levels: Useful in determining whether you can or should change your medication dose.

If you are not responding to anti-seizure medications, your epilepsy physician may suggest additional testing, such as inpatient video EEG monitoring in the Epilepsy Monitoring Unit.

Surgical Treatment for Epilepsy

For some people, medications alone aren’t enough to get complete relief from seizures. In these cases, surgery may be an option. Individuals who undergo successful epilepsy surgery may have a better quality of life than those who continue on medications alone with poor seizure control. Even after surgery, many patients have to continue some medication for the best seizure control. 

Epilepsy surgery isn’t new; it has been performed for more than 100 years. In the past 50 years, there’s been steady improvement and success in surgical treatment of epilepsy. 

Miami Valley Hospital is experienced in performing a complete range of epilepsy surgical procedures. We offer temporal lobectomy and other surgeries that involve removing the area of the brain where seizures originate. We also perform procedures such as focal resections, hemispherectomy and corpus callosotomy, which are designed to block a seizure’s electrical spread.

Some people may benefit from an implantable device such as the vagus nerve stimulator. This is a pacemaker-like device that is implanted under the collarbone. The vagus nerve stimulator delivers regulated electrical signals to the brain, reducing the number, as well as the intensity, of seizures.

Evaluation for Surgery

Patients considering surgery generally go through a four-step evaluation process to plan the surgery and make sure it will provide the safest outcome. 

Step 1: Non-Invasive Studies and Team Evaluation

Patient and physician discuss the patient’s seizure history and what types of treatment have been tried. If you and your doctor decide you might benefit from surgery, you may have additional testing to help further characterize your seizures, including:

  • Electroencephalogram (EEG) — An EEG measures and records the brain's electrical activity. This test may show abnormalities that point towards a specific type of epilepsy and may help guide your physician’s treatment recommendations. An EEG takes about 40 minutes and involves pasting small wires on the head. 
  • Video/EEG telemetry monitoring — VEEG monitoring continuously record your spells, using EEG and video, while you are a hospital inpatient. Recording your brain waves 24/7 over a period of several days allows us to capture your spells, determine if they are seizures or some other condition, and possibly pinpoint their origin in your brain.
  • Brain MRI — An MRI scanner uses a strong magnet to take very detailed pictures of the brain. These pictures may show structural abnormalities which can give rise to seizures and may help define treatment options. Special protocols are used to identify the often subtle changes in the brain that indicate where seizures may be arising.
  • Functional MRI (fMRI) — Special MRI protocols may be used to visualize where motor, language, visual or even memory tasks are performed in an individual's brain.
  • Blood Flow and Metabolism Imaging — Studies such as single photon emission computerized tomography (SPECT) or positron emission tomography (PET) may give clues to where seizures are originating in the brain.
  • Neuropsychological Testing — Specialized tests for cognitive, language, memory and motor skills, given in a specialist’s office, may reveal changes due to seizures in focal brain areas and help determine the areas of brain function that might be at risk from surgery

After obtaining necessary non-invasive studies, the Miami Valley epilepsy team will discuss the patient at its multidisciplinary conference. Here all of the members of the epilepsy team review the studies and determine if a patient is a good candidate for epilepsy surgery or vagus nerve stimulation. The epilepsy team comprises several epileptologists (neurologists who specialize in epilepsy), an epilepsy surgeon, a psychologist specializing in epilepsy, an epilepsy social worker, epilepsy nurses and EEG technologists. 

If the team agrees that the benefits of epilepsy surgery outweigh the risks, we will arrange for you to consult with our epilepsy surgeon. Our surgeon will discuss the type of surgical options available, as well as any further testing that may be necessary prior to surgery.

Step 2: Intracranial Monitoring 

Sometimes video EEG monitoring with electrodes on the scalp does not provide enough information to show exactly where your seizures begin. In this situation, we may recommend additional video EEG monitoring, this time using very thin, soft electrodes placed on the surface of the brain by the surgeon in the operating room, with the patient under anesthesia. This type of monitoring, called intracranial monitoring, gives much more precise information about where seizures begin. Functional testing may also be performed at this time to determine if seizures arise from critical brain areas.

Step 3: Wada Test

This specialized form of testing uses anesthesia medications to help map the parts of the brain that must be protected during surgery, and helps your doctor decide whether epilepsy surgery is safe for you.

Step 4: Surgery

Once your doctor understands precisely the brain region responsible for generating your seizures, a decision regarding treatment can be made. The risks of surgery will be discussed, and all other options will be weighed. You and your doctor will make a decision together about treatment strategy. This may involve removing brain areas responsible for seizures such as focal excision, lobectomy or hemispherectomy. Or treatment may be a disconnection therapy, such as corpus callosotomy or multiple subpial transactions. Alternatively, a vagus nerve stimulator may be recommended.

Neurophysiology Laboratory

The neurophysiology laboratory at Miami Valley Hospital is a critical component of the epilepsy program, offering a number of inpatient and outpatient services. They include video electroencephalography (EEG) monitoring in the Epilepsy Monitoring Unit, adult and neonatal outpatient EEG, as well as adult visual, auditory, and somatosensory evoked potentials. Miami Valley maintains its position as a leader in neurophysiology services by:

  • Maintaining technologically advanced equipment and facilities
  • Providing ongoing clinical education 
  • Promoting a culture of safety

Clinical Trials and Research

Miami Valley’s epilepsy specialists participate in clinical trials and research to advance treatments for epilepsy and other seizure disorders. For more information, ask your neurologist about studies you may be able to join.

Your Epilepsy Team

Miami Valley Hospital’s fellowship-trained and board-certified epilepsy specialists use their extensive training and experience to help patients understand and manage epilepsy and other seizure disorders. Our specially trained nurses and technologists collaborate with our physicians to ensure patients receive personalized, compassionate care. Find a Physician.

Preparing for Epilepsy Treatments 

Premier Health Library

The Premier Health Library offers a wealth of information about epilepsy treatments and neurosciences. Learn about conditions, treatments, how to prepare for a surgery, and much more.

Content Updated: August 14, 2017


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These Miami Valley Hospital locations offer Neurosciences Services.
Neurosciences at Miami Valley Hospital
One Wyoming St. Dayton, OH  45409
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