Epilepsy is a disorder characterized by recurrent seizures. Seizures are caused by abnormal activity of nerve cells, called neurons, in the brain. In the United States, about 2 million people have epilepsy and as many as 150,000 more develop the condition each year. About a third of them are children.
Epilepsy has many possible causes, such as an imbalance of nerve-signaling chemicals, called neurotransmitters, or abnormal nerve connections that form after an injury such as head trauma or stroke. Other types of epilepsy run in families and have been tied to specific genes. Often, it may be difficult to understand why a specific person develops epilepsy, but this does not mean that effective treatment is impossible.
The Epilepsy Center at UCSF Medical Center provides diagnostic and treatment services that have earned us a level four rating — the highest level available — from the National Association of Epilepsy Centers. We specialize in providing comprehensive care for all types of epilepsy, including epilepsy that has not responded to treatment, called medically refractory epilepsy.
The center's neurodiagnostic program uses magnetic resonance imaging (MRI) and positron emission tomography (PET) to provide images of the brain, as well as electrical studies such as an electroencephalogram (EEG) to record brain waves. We also use advanced imaging techniques such as magnetoencephalogram and magnetic source imaging (MEG/MSI) and brain SPECT scans to help pinpoint the source of the seizures in the brain.
Treatments may include medication, traditional brain surgery, laser ablation, vagal nerve stimulation and reactive neural stimulation. Patients also have the opportunity to participate in studies, called clinical trials, to test the latest experimental treatments. Clinical trials make new drugs, therapies and surgical procedures available to patients before they're widely available to the general public.
Seizures are divided into two categories: generalized and focal.
Generalized seizures are caused by abnormal electrical impulses in the brain and typically occur with no warning. There are six types of generalized seizures.
During your visit to the Epilepsy Center, we will record your medical history — as well as your family's medical history — and conduct diagnostic tests. Your neurologist will determine the type of seizures you're having and the cause. If you're diagnosed with epilepsy, your doctor will identify the specific type you have to determine the best treatment.
We will ask many questions about your seizures. If you lose consciousness during your seizures, please bring a family member or friend who might help describe what happens during your seizures.
Some of the questions will include:
Your neurology team at the Epilepsy Center, along with your primary care doctor, will design a treatment plan tailored to your condition and individual needs. You may require more than one kind of treatment — such as medication and surgery — and may be referred to other medical professionals.
Most seizures can be prevented with medication. The type of medication prescribed will depend on your condition. Your neurologist will explain how to take your medication and what side effects might occur. Over time, your medication may be changed to find the right drug and dose. Be sure to take your medication as directed. Call your neurologist if you have questions or experience any unexpected side effects.
For some patients, surgery may be recommended to prevent seizures or to implant devices that deliver medications or stimulators to emit electrical impulses. Your neurologist will explain the procedure as well as possible risks.
Reviewed by health care specialists at UCSF Medical Center.