Epilepsy Treatment & Procedures
With the information we gather during your evaluation, our epileptologists (doctors with special training in epilepsy care), neurologists, neurosurgeons, neurophysiologists, neuropsychologists, psychiatrists, and neuroradiologists work together to customize your treatment . They collaborate with a team of nurses, social workers, language therapists, and occupational and physical therapists to provide the best care for you. Your treatment may include:
- Antiseizure medicationsThese drugs are effective in about two-thirds of people with epilepsy. We'll try a variety of medications to see if we can find one that works well for you.
- Investigational therapies. You may be eligible to participate in a clinical trial of a new epilepsy treatment. Our researchers played a significant role in the development and assessment of most of the new antiseizure mediations available today. We continue to conduct clinical trials of new epilepsy drugs.
Some people with epilepsy benefit from dietary changes that can reduce the frequency of their seizures. We offer nutritional guidance for epilepsy, such as how to follow a high-fat ketogenic diet, a low glycemic index diet, or a modified Atkins diet. Our registered dietitian can teach you how to incorporate new dietary changes into your life.
Because of advances in brain imaging, we can now recognize subtle structural brain abnormalities that cause epilepsy. As a result, certain people are now candidates for epilepsy surgery who may not have been considered for this treatment in the past.
- Vagus nerve stimulation (VNS). We use VNS for some children and adults with epilepsy whose seizures are not well controlled with medication. We have the most experience in the mid-Atlantic region with VNS—a small pacemaker-like device implanted under the skin in the chest which sends small electrical impulses to the left vagus nerve to control seizures.
- Responsive neurostimulation (RNS). RNS is a therapy for adults with partial onset seizures that cannot be controlled with medication. Surgeons implant the RNS device into the skull. Electrodes placed on the brain detect abnormal electrical activity. The RNS device then responds by delivering electrical stimulation to normalize brain activity before a seizure occurs. NewYork-Presbyterian was involved in the original clinical trials that studied this device and led to its approval.
- Minimally invasive epilepsy surgery. For people with clearly localized seizure sites (foci) that may be difficult or risky to access with traditional surgery, we offer minimally invasive techniques called laser interstitial thermal therapy (LITT- also known as laser ablation) and stereotactic radiosurgery (SRS). Using computer-guided navigation, both of these techniques allow the surgeon to attempt to eliminate the seizure focus without making a large opening in the skull. Aided by MRI, the surgeon guides a laser through a three-millimeter incision and into the focus of a seizure to destroy the brain tissue causing seizures. Most people are able to go home the next day.
- Traditional surgery. For many people with epilepsy, their best chance of becoming free of seizures is to identify and remove the area of the brain where their seizures are arising. Our surgeons perform these surgeries with great success and have pioneered new techniques. We use brain mapping before and during surgery to carefully define regions of the brain near the area being considered for surgery. We may interrupt nerve fibers on the surface of the brain that carries the signals causing epilepsy symptoms or remove the specific area of the brain that is triggering seizures.