What is epilepsy?

Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures. A seizure is a sudden, uncontrolled disturbance in the brain caused by abnormal electrical activity. These electrical disturbances can affect many brain functions, leading to a wide range of symptoms, including temporary confusion, staring, uncontrolled movements, or loss of consciousness. The World Health Organization estimates that around 50 million people worldwide have epilepsy, which makes it one of the most common neurological conditions in the world.

At AHN, our team of epilepsy experts understand how this disorder can affect people differently and have the understanding, compassion, and experience to create personalized treatment plans for each of our patients. We specialize in using new and emerging therapies and provide clear explanations on your medication choices, potential therapies, and other lifestyle modifications, so you feel confident in your care plan. 

AHN Joseph and Kathleen Guyaux Comprehensive Epilepsy Center

At the Joseph and Kathleen Guyaux Comprehensive Epilepsy Center, we provide comprehensive diagnosis and treatment services to address every aspect of your epilepsy care in one place. Our epilepsy specialists use advanced technology to give you a precise diagnosis and, most importantly, we will create a personalized treatment plan specifically designed for your unique needs and goals. The epilepsy center is located at Allegheny General Hospital, which is home to a Level I Adult Trauma Center that provides the highest level of surgical and medical care available.

Uncontrolled seizures caused by epilepsy are disruptive and can significantly impact your life. At AHN, we provide the resources you need to manage both the physical and emotional effects of epilepsy so you can live your best life, with greater independence and confidence.

Why choose AHN for your epilepsy

When you choose AHN, you're choosing a dedicated team committed to providing world-class epilepsy care that puts you first. We provide our patients with:

• Multidisciplinary team of experts: You benefit from a collaborative team of highly specialized professionals, including epileptologists (a neurologist who has specialized training in epilepsy), neurosurgeons, neuropsychologists, neuroradiologists, nurses, social workers, and physical, occupational, and speech therapists. This comprehensive approach ensures every aspect of your condition is thoroughly evaluated and addressed.
• Coordinated care model: We ensure seamless communication and integration across all specialties and services. From your initial diagnosis through ongoing treatment and support, our coordinated care model means you have a dedicated team working together, providing a clear path forward and eliminating fragmented care.
• Patient-centered care philosophy: Your well-being and quality of life are at the heart of everything we do. We prioritize understanding your personal challenges and goals, involving you in every decision, and empowering you with the knowledge and tools to effectively manage your epilepsy. We don't just treat your seizures; we treat you.
• Advanced diagnostic and treatment technologies: Our center is equipped with state-of-the-art technology for precise diagnosis and effective treatment, including advanced neuroimaging, video-EEG monitoring, and access to the latest anti-seizure medications, surgical options, and device therapies.

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Erie Region

Quick guide to epilepsy

Epilepsy symptoms and signs

Epilepsy screening and diagnosis

Types of epilepsy

Epilepsy treatment

Epilepsy FAQs

Contact us

Epilepsy symptoms and signs

People experience seizures differently, and the specific symptoms depend on the area of the brain where the seizure activity originates. Common symptoms, which are often intermittent or episodic, include, but are not limited to:

• Staring blankly
• Twitching or jerking movements that you can’t control
• Violent muscle spasms
• Confusion or anxiety
• Fainting or loss of consciousness
• Panic attacks
• Déjà vu
• Feelings of depersonalization (feeling detached from yourself)

Causes and risk factors

Epilepsy can affect anyone, at any age. While in many cases the exact cause is unknown, various factors can contribute to its development or increase the risk of experiencing seizures. Understanding these potential causes is an important step in diagnosis and treatment.

• Brain conditions: Conditions that affect the brain's structure or function can be a significant cause. This includes brain tumors, which are abnormal growths that can press on brain tissue and disrupt normal electrical activity, leading to seizures. Learn more about brain tumors.
• Brain infections: Certain infections can cause inflammation or damage to the brain, triggering epilepsy. An example is autoimmune encephalitis, a condition where the body's immune system mistakenly attacks healthy brain cells, causing inflammation and neurological symptoms including seizures. Learn more about autoimmune encephalitis.
• Stroke and vascular diseases: Damage to the brain from reduced blood flow or a ruptured blood vessel can lead to epilepsy. Stroke, for instance, is a leading cause of epilepsy in older adults, as the damaged brain tissue can become a source of abnormal electrical activity. Learn more about strokes.
• Genetics: Some types of epilepsy run in families, suggesting a genetic influence. While inheriting specific genes doesn't automatically mean you'll develop epilepsy, certain genetic mutations can make a person more susceptible to seizures.
• Head trauma: A severe blow to the head, such as from a car accident or sports injury, can lead to brain damage that sometimes results in epilepsy. Post-traumatic epilepsy can develop immediately or years after the injury.

Epilepsy screening and diagnosis

Our care team specializes in treating patients with epilepsy. We get to know your entire medical history and any life experiences that may put you at higher risk for epilepsy. After a thorough physical examination, your physician may recommend one or more tests, including:

• Electroencephalogram (EEG): This test measures your brain’s electrical activity, using tiny electrodes attached to your head. Learn more about an EEG.
• Functional magnetic resonance imaging (fMRI): This specialized MRI can pinpoint the parts of the brain responsible for speech and movement.
• Magnetic resonance imaging (MRI): Physicians may use this advanced imaging test, which produces detailed images of internal structures, to look for other causes of your symptoms.
• Neuropsychological testing: Memory and other cognitive tests can help physicians determine which part of the brain may be causing your symptoms. These tests can also flag emotional difficulties, such as anxiety, that we can address to improve your quality of life.
• Positron emission tomography (PET): This imaging test tells physicians how the brain metabolizes glucose, helping pinpoint areas that are not working properly.
• Robotic stereoelectroencephalography (SEEG): With this surgical diagnosis tool, neurosurgeons use robotic assistance of the ROSA ONE®² Brain robotic platform for precision and safety to place electrodes directly into the brain. These electrodes monitor electrical activity and determine which areas of the brain are creating seizures and then removed safely after EEG monitor.

Types of epilepsy

Epilepsy isn't a single condition; it's a spectrum of neurological disorders. Because seizures can affect everyone differently, doctors classify epilepsy to better understand your specific situation and guide the most effective treatment. This classification helps us understand where in the brain seizures might start and how they spread.

It's important to remember that receiving an epilepsy diagnosis is the first step toward gaining control. Our team is here to help you understand your specific type and stage, ensuring you receive the most personalized and effective care.

Different types of seizures

 Seizures are typically classified by where they begin in the brain:

• Focal onset seizures (partial seizures): These seizures start in just one specific area of the brain. The symptoms you experience will depend on which part of the brain is affected.
• Focal onset aware seizures (formerly simple partial seizures): You remain fully conscious and aware during these seizures, though you might experience unusual sensations, movements, or emotions. For example, you might feel a sudden odd smell, a twitch in one limb, or a feeling of déjà vu.
• Focal onset impaired awareness seizures (formerly complex partial seizures): During these seizures, your awareness is affected. You might stare blankly, make repetitive movements like lip smacking or fumbling with clothes, or seem confused. You won't remember what happened during the seizure.
• Generalized onset seizures: These seizures begin simultaneously in both sides of the brain. They nearly always affect consciousness.
• Tonic-clonic seizures (formerly Grand Mal Seizures): This is often what people think of as a "typical" seizure. You lose consciousness, your body stiffens (tonic phase), and then your limbs jerk rhythmically (clonic phase).
• Absence seizures (formerly Petit Mal Seizures): More common in children, these involve brief lapses in awareness where you might stare blankly for a few seconds. You typically won't fall or have convulsions, and usually won't remember the seizure afterward.
• Atonic seizures (Drop Attacks): These cause a sudden loss of muscle tone, leading you to fall abruptly.
• Clonic seizures: Characterized by rhythmic jerking movements, usually of the arms and legs.
• Tonic seizures: Cause a sudden stiffening or tensing of muscles, often affecting the back, arms, and legs.
• Myoclonic seizures: Brief, shock-like jerks of a muscle or group of muscles.
• Unknown onset seizures: If a doctor can't determine where the seizure began, it might be classified as an unknown onset seizure. This might happen if the seizure wasn't witnessed, or if monitoring couldn't pinpoint the origin. Further testing can sometimes help reclassify these later.

Understanding epilepsy syndromes and stages

Beyond just seizure types, epilepsy is also classified into different epilepsy syndromes and often discussed in terms of its stage of management.

• Epilepsy syndromes: These are distinct conditions defined by a cluster of features, including the type of seizures, age of onset, specific EEG patterns, and typical outcomes. Examples include Childhood Absence Epilepsy or Lennox-Gastaut Syndrome. Identifying a syndrome can give you and your care team a clearer picture of what to expect and the most effective treatment strategies.
• Stages of epilepsy management: While not formal medical "stages" like in cancer, it's helpful to think about the journey of epilepsy treatment in phases.

Navigating epilepsy can feel overwhelming, but you are not alone. Our dedicated team at the Joseph and Kathleen Guyaux Comprehensive Epilepsy Center is here to guide you through every step, providing clarity, compassionate care, and the most advanced treatment options available.

Epilepsy treatment

We use the latest treatments, which may include medication, surgery, or both. Your care team will tailor a treatment plan that addresses your needs. Our goal is to find therapies that manage your symptoms and maximize your quality of life.We may recommend one or more of these treatments.

Medication

Medications effectively control seizures for two-thirds of people with epilepsy. We offer more than 25 different epilepsy medications that help treat seizures. Sometimes finding the right combination of medications and dosage may take a few months. Your physician will work closely with you to determine which combination is best for you.

We participate in multiple research studies that pursue new treatments for epilepsy. We can offer our patients the latest treatments, such as new medications, before they are widely available.

Surgery

If you have recurrent seizures despite trying at least two different anti-epileptic medicines, then you may be a candidate for surgery. Our fellowship-trained surgeons have expertise in performing intricate robotic and minimally invasive surgical procedures to treat patients whose symptoms are not controlled with medications. Our advanced testing helps us determine which part of the brain causes your seizures, so we can use the most effective surgical approach. Surgical treatment options include:

• Laser ablation: For patients whose epilepsy comes from areas deeper in the brain, our neurosurgeons can use a thin laser to ablate, or remove, the troublesome area through a small, barely perceptible, incision.
• Neuromodulation:
  • Deep brain stimulation (DBS): Electrodes are placed in a precise location in the brain and a device is connected and implanted in the skin under the clavicle, like a pacemaker. This device stimulates the brain to help reduce seizure activity. Learn more about deep brain stimulation.
  • Responsive neuromodulation (RNS): This procedure is the most recent in brain stimulation for epilepsy. During this procedure, an FDA-approved device is implanted onto the brain’s surface. It then sends electrical impulses to the area of the brain causing seizures and prevents them from occurring or spreading.
  • Vagus nerve stimulation (VNS): A device about the size of a silver dollar is implanted under the skin during this procedure. A thin wire is then placed on the vagus nerve in the neck and electrical energy is sent through this nerve to the affected areas of the brain causing seizures. Learn more about VNS.
• Resective surgery: During this surgery, the neurosurgeon will carefully treat the portion of the brain that is causing the seizure.

If your seizures persist after trying multiple treatments, your physician may ask you to undergo advanced testing in our Epilepsy Monitoring Unit so we can learn more about your symptoms. At this unit, located at Allegheny General Hospital, you receive care from dedicated nurses and doctors who are trained in epilepsy.

Epilepsy FAQs

Navigating an epilepsy diagnosis or understanding the condition can bring up many questions. It's completely normal to feel this way, and we're here to provide clear, compassionate answers. We understand that accurate information is crucial for your peace of mind and for making informed decisions about your health. Below, we've addressed some common questions to help you better understand epilepsy. Please remember that this information is for general guidance, and we encourage you to discuss your specific concerns with our expert care team.

What causes seizures?

Seizures are caused by sudden, uncontrolled bursts of electrical activity in the brain. In many cases, especially with a single seizure, the exact cause might not be identified. However, when seizures are recurrent and unprovoked (meaning not triggered by an obvious, reversible cause like extremely low blood sugar or alcohol withdrawal), they are classified as epilepsy. Potential causes for epilepsy can include genetic predispositions, head injuries, strokes, brain infections (like meningitis or encephalitis), brain tumors, or developmental brain disorders. Sometimes, despite extensive testing, no clear cause is found. Our specialists work diligently to identify any underlying cause to guide your treatment plan effectively.

How is epilepsy diagnosed?

Diagnosing epilepsy involves a comprehensive approach by our specialized team. It typically begins with a detailed review of your medical history and a thorough neurological examination. We'll ask about your seizure experiences, any warning signs, and what happens during and after a seizure. Key diagnostic tools often include:

• Electroencephalogram (EEG): This test records the electrical activity of your brain, which can help detect abnormal patterns associated with seizures. Sometimes, prolonged EEG monitoring (video-EEG) is necessary to capture a seizure event.
• Imaging scans: Magnetic Resonance Imaging (MRI) of the brain is crucial to look for any structural abnormalities, such as tumors, scars, or areas of prior injury, that could be causing seizures.
• Blood tests: These can help rule out other conditions that might cause seizures, such as infections, electrolyte imbalances, or genetic conditions.

Our experts carefully analyze all this information to accurately diagnose your type of epilepsy and develop a personalized treatment strategy.

Can epilepsy be cured?

Currently, there is no universal cure for epilepsy. However, the good news is that epilepsy can be effectively managed and controlled for a significant majority of patients. For about 7 out of 10 people with epilepsy, seizures can be well-controlled with medication, allowing them to live full and active lives. In some cases, especially in children, epilepsy can even go into remission, meaning seizures stop occurring and medication may eventually be discontinued.

For those whose seizures are not controlled by medication (drug-resistant epilepsy), advanced treatments like epilepsy surgery or device therapies (such as vagus nerve stimulation, responsive neurostimulation, or deep brain stimulation) offer excellent prospects for significant seizure reduction or even freedom from seizures. Our goal is always to help you achieve the best possible quality of life, with minimal or no seizures.

Contact us

To schedule an appointment or learn more about services at the Joseph and Kathleen Guyaux Comprehensive Epilepsy Center call 412-359-8850.