UVa's Epilepsy Program
Epilepsy surgery has traditionally been viewed as a last resort, but recent advances in the surgical treatment of epilepsy offer the possibility of a safe, effective cure and improved quality of life. Physicians at the University of Virginia Health System prefer to evaluate patients for surgery early in their course of treatment, to minimize the long-term consequences of chronic epilepsy and anti-seizure drugs.
UVa's F.E. Dreifuss Comprehensive Epilepsy Program is a Fourth-Level Center for Epilepsy, which is the highest designation of the National Association of Epilepsy Centers. The program offers the most advanced resources available, and is comprehensive not only in terms of the multidisciplinary team approach to care, but also in the team's ability to apply every available diagnostic and treatment option.
Testing
To determine if a patient is a candidate for surgery, UVa's team of physicians considers whether the origin of the seizures is likely to be localized to one small region and an operation can be performed without adversely affecting critical brain functions.
After establishing that a patient could potentially benefit from surgery, a diagnostic evaluation is performed to determine overall suitability for surgery, as well as to localize the seizure focus. This evaluation includes baseline and prolonged video EEG monitoring, high-resolution MRI, ictal SPECT scanning, and neuropsychologic testing. Other diagnostic tests, such as PET-CT scanning and functional MRI are obtained when needed. Intracranial electrodes are considered when these tests do not sufficiently localize the site of seizure onset.
Surgery and Outcomes
The most frequent type of surgery for epilepsy is temporal lobectomy, which is performed for intractable complex partial seizures and secondarily generalized seizures that arise in the temporal lobe. Extra-temporal lobe surgery is another form of surgery available when seizures begin outside of the temporal lobe.
Neurosurgeons at UVa have conducted more than 200 temporal lobectomies since 1991. Assessed two years after surgery, 74 percent of these patients were essentially seizure-free. "Essentially" means that some patients continued to have auras -- subjective symptoms associated with the onset of a partial seizure. (A subset of this group with typical MRI findings experienced a 91 percent essentially seizure-free rate.) Many patients have been able to decrease the amount of anti-seizure medications they take, and in some cases, they have discontinued medications completely. The risk of a serious complication is less than 1 percent.
As a leader in epilepsy treatment, UVa continues to offer a wealth of options, and our multidisciplinary team will always consider the full range available, including vagus nerve stimulation and the latest drugs. Patients can participate in clinical trials for epilepsy, including six newly developed drugs, a study of early temporal lobectomy, gamma knife treatment of temporal lobe epilepsy, and two implantable devices, including deep brain stimulation.
To find out more or to make an appointment, call 888-882-3435.
Learn more about the applications of functional neurosurgery at UVa.
When considering any medical procedure, it is important to be informed about its potential risks and benefits. This information is not intended to be a substitute for consultation with a qualified health professional familiar with your individual medical needs. UVa recommends that you consult a physician or other qualified health care provider for medical advice and treatment.
