Providence Epilepsy Center
Providence Epilepsy Center
Providence Epilepsy Center delivers evidence-based and technologically-advanced individual treatment plans. Our approach unites caregivers from several medical fields to provide the full range of coordinated and compassionate care and includes medical, nursing, educational, social, psychological and surgical services.
Our center also includes the Providence First Seizure Clinic, which streamlines care for patients with new onset seizures by providing fast access to diagnostic testing and consultation with one of our epileptologists.
Providence Epilepsy Center is accredited by the NAEC as a level 4 epilepsy center. Level 4 epilepsy centers have the professional expertise and facilities to provide the highest level of medical and surgical evaluation and treatment for patients with complex epilepsy.
A seizure is an interruption of normal brain function caused by overly excited nerve cells (neurons) in the brain. A person having a seizure might lose consciousness, stare, have jerking of the arms and/or legs, have trouble talking, make strange noises or express strange feelings.
Epilepsy is usually defined as having two or more seizures that do not have a specific cause. However, even if you’ve only had a single seizure, you could be diagnosed with epilepsy if your tests suggest that future seizures are highly likely. To find out, your doctor may order blood tests, an EEG (electroencephalogram), an MRI (magnet resonance imaging) test or a CT (computerized tomography) scan. These tests, plus your history and neurological exam, will help to reach a diagnosis.
Yes, some people have several different types of seizures. A diagnosis of “epilepsy” is nonspecific about which type you may have, and different epilepsies or epilepsy syndromes may have different treatments and prognoses.
Some children do stop having seizures as they age. If you go two or three years without a seizure, you may decide with your doctor to stop taking seizure medications. Your risk of future seizures after you stop medication depends on the underlying cause of your seizures and other genetic, medical and social variables.
While there is no cure, taking medications and avoiding situations that increase your risk of having a seizure can help control it.
Among patients whose seizures can’t be controlled with medication, a small subset may be able to stop or significantly decrease seizures with surgery. If surgery stops the seizures, however, most patients will still require anti-seizure medication. Other options for some who don’t respond completely to medications may include implanted devices (vagal nerve stimulators are the most common) that can reduce seizures, or a trial of an epilepsy diet therapy. Even with treatment, though, some people will continue to have seizures.
The vagal nerve stimulator (VNS) is a treatment option for some patients who are not candidates for surgery. VNS placement requires a simple outpatient procedure under anesthesia. A small programmable device is inserted in the chest wall (similar to a pacemaker). It has a flexible wire that wraps around the vagus nerve, which is a nerve that starts in the lower part of the brain and extends down into your torso.
The VNS is programmed to send a small electrical current intermittently to the vagus nerve. This interrupts the electrical activity in the brain. The most common side effects of the VNS are hoarseness, discomfort, and cough. The VNS settings are gradually increased over time. In the event of a seizure, a magnet can be swiped over the battery site. This will often stop or shorten a seizure. VNS therapy is used along with medications. It may allow you to take less medication and have fewer side effects, or it may work synergistically with your medication.
No, epilepsy is not contagious.
Most patients don’t need to have their blood levels checked at every visit. While there are generally recognized guidelines for how much of a drug should be present in your blood in order for the drug to be effective, not all patients do their best within these “therapeutic ranges.” The right drug dose for you should be balanced between how often you have seizures and how well you handle side effects.
Blood levels do provide helpful safety information if you are pregnant or if you are taking another medication that might interact with your antiepileptic drug. These tests also show your doctor whether you are taking your medication correctly. With certain medications, frequent monitoring of your blood count, electrolytes and liver enzymes is important.
Some people who don't understand epilepsy may be afraid of it. You should consider carefully whom you would like to know about your condition. There are laws in place, such as the Americans with Disabilities Act, that prevent discrimination in the workplace. It can be less scary to others if you describe what your seizures look like and how people can help you when you’re having one. You also can choose to wear a medical alert bracelet, or to carry a wallet card stating that you have epilepsy and listing a person to contact if you have a seizure.
No. The DMV does require mandatory reporting of drivers who lose consciousness. They take the information provided by your health care provider and then review your case. If you have been controlled on medication for three to six months, you may reapply for your license. Driving laws vary from state to state; if you have experienced a seizure, you should contact your local DMV and your doctor for questions related to driving.
Every patient is different. Ask your doctor about an individualized plan for how to adjust your seizure medication in the event of a seizure. In some situations, your doctor may provide you with a special “rescue” medication to be taken after a seizure.
If you miss a dose, you are more likely to have a seizure. Take a dose as soon as you remember or at the next time that you’re normally scheduled to take it. If you take two doses close together, you may notice more side effects. If you are ever uncertain about when or how to take your medication, contact your doctor for instructions.
The different antiepileptic drugs all have different ways of working and different side effects. The different types of side effects include:
- Drug-initiation side effects: These may happen in the first two to three weeks after starting a new medicine, when your body is still getting used to the drug.
- Dose-dependent side effects: These occur only at a certain dose.
- Drug-related side effects: These are related to the drug itself and may include allergic reaction, liver failure and changes in your blood count.
If your side effects are bad enough that you feel you need to stop taking your medication, talk to your health care provider. Explain how you are feeling so your provider can give you instructions to help you safely taper off the medication.
Don’t wait to report the following side effects:
- A painful rash that is all over your body (not just one side)
- Bleeding that doesn’t stop
- Abdominal pain and yellowing of the eyes or skin
- Fever or unusual infections that do not go away
Besides taking medication, is there anything I can do to prevent seizures? Be aware of the most common factors that may trigger a seizure, including stress, not getting enough sleep, flashing lights, rapid breathing, menstruation, taking drugs or alcohol, and drinking too much caffeine. It’s important for people with epilepsy to try to get plenty of sleep, to exercise regularly, to use stress-management techniques and to maintain a healthy lifestyle.
Certain prescription medications also can make it easier for you to have a seizure. If you notice that you’re having more seizures after starting a new medication, be sure to notify your doctor right away.
If someone is having convulsions (known as a tonic-clonic or grand mal seizure): help the person down to the ground if he or she is falling. Move any dangerous objects out of the way. Place something soft under the person’s head if you can. After the seizures stop, help the person onto his side. Do not move the person if you think that he might have a neck or back injury from the fall.
Do not place anything in the person’s mouth – he will not swallow his tongue. When the person regains awareness, he may be confused and tired. Someone should stay with him until he is back to normal. Tell the person that he just had a seizure.
If someone is having a seizure without convulsions: The person may be staring blankly, having trouble finding words, wandering or behaving differently. The most helpful thing to do is to stay with the person and talk to him during the seizure. If he is wandering, try to verbally steer him away from danger. Keep in mind that the person may or may not be able to hear you.
Yes. Most women with epilepsy are able to get pregnant and have a normal healthy baby. This requires advance planning and close observation from your doctors. You may need to get frequent blood draws. After the baby is born, there are safety guidelines you can follow to keep your baby safe if you have a seizure.
Genes do play a small role in epilepsy. Some epilepsy syndromes are more likely to be passed on genetically than others.