Epilepsy: Diagnosis, Treatment, Control

It starts when a cluster of brain cells begins to emit rapid, rhythmic and repetitive electrical discharges. The malfunction may remain confined to a small section or it may spread throughout the entire brain. The result is a seizure. It may manifest as a fleeting episode of staring, a sudden drop attack, or a prolonged, life-threatening convulsion. The incidence of recurrent seizures makes up the phenomenon known as epilepsy. Although it was first recognized thousands of years ago, only in recent decades have effective treatments been developed to treat this devastating disorder.

Today, seizures and epilepsy develop in approximately 181,000 Americans of all ages each year. Stroke, cardiovascular disease, brain tumors and Alzheimer's disease are all causes of epilepsy in those over the age of 65. Overall, more than 2 million people have been diagnosed with epilepsy. Repeated seizures can damage developing brains, which can irrevocably alter a child's life. Uncontrollable seizures can affect employment and family life, presenting barriers to independence.

Thanks to new medications and other forms of treatment, the control of seizures is an attainable goal for many people. The Hahnemann Comprehensive Epilepsy Center is dedicated to providing a full range of treatment options for people with epilepsy and helping to improve quality of life.

Outpatient Services

The center offers comprehensive evaluation, and diagnostic treatment at our office at 219 N. Broad Street, located directly across the street from the hospital. Patients with various types of epilepsy receive physician services, full counseling, education, monitoring of seizure medication levels as well as other diagnostic testing with EEG, MRI, MR Spectroscopy and SPECT scanning to further evaluate the epileptic disorder.

When outpatient management fails to control seizures and if the patient is an appropriate candidate for potential epilepsy surgery, further inpatient evaluation may be pursued. This includes inpatient epilepsy monitoring, enrollment in drug trials, and/or implantation with vagus nerve stimulation.

Epilepsy Monitoring Unit

Patients with intractable episodes whose epilepsy diagnosis remains uncertain after out- patient evaluation may be admitted to our inpatient epilepsy-monitoring unit (EMU). Located at Hahnemann University Hospital, this unit consists of three hard-wired beds that allow technicians to video tape clinical seizures and record an EEG simultaneously. This higher level of technology helps provide us with a clear diagnosis of most types of epilepsy, defines the location of the seizure focus in the brain and aids in the establishment of a treatment plan.

The diagnostic procedures performed in the EMU include:

· Continuous audiovisual/EEG monitoring--Allows recording of the electrical activity during the seizures

· EEG Source Imaging--Allows a most sophisticated analysis of EEG and direct visualization of the likely seizure focus on the patient's brain using our Curry software system

· MRI-- Reveals a structural brain abnormality causing epilepsy

· MR Spectroscopy--Localizes the seizure focus non-invasively

· SPECT Scan--Shows the region of the brain likely causing epileptic seizures

Surgical Options

After diagnostic tests are performed, some patients may be eligible for epilepsy surgery. When indicated, epilepsy surgery is performed using sophisticated computerized neurosurgical techniques. The seizure focus is resected with the goal of achieving complete seizure control.

Patients may also be offered vagal nerve stimulation, a short surgical procedure in which a small electrical device is implanted. This procedure may be helpful in improving seizure control. This service is also offered through our multi-disciplinary team, which includes neurology, epilepsy and neurosurgery services.


Research and Education

Patients may benefit from numerous research activities conducted by the Epilepsy Center including:

· EEG Source Imagingallows non-invasive localization of the seizure focus.

· MR Imaging and MR Spectroscopy aids in the non-invasive localization of the seizure focus.

· Functional MRI Research Programconducted in collaboration with the department of radiology, this non- invasive technique uses functional MR imaging to localize the seizure focus. Currently this is offered to patients with intractable epilepsy.

· Experimental Anti-Seizure Medication Trialsconducted at our Epilepsy Center to treat patients with various types of intractable epilepsy.

Educational services include support groups and programs that are aimed at providing resources to improve quality of life for patients with epilepsy.


The Hahnemann Comprehensive Epilepsy Center Team:
consists of neurologists, epileptologists, neurosurgeons, epilepsy monitoring unit technicians, neuropsychologists, and trained epilepsy and neurosurgery nursing staff.

Bassam A. Assaf, MD, director, neurologist and epileptologist

Warren Goldman, MD, professor and chairman, Department of Neurosurgery

Divya Khurana, MD, pediatric neurologist and epileptologist

Scott Faro, MD, neuroradiologist

Robert Koenigsberg, MD, neuroradiologist

Feroze Mohamed, PhD, MR physicist

Sandra Koffler, MD, neuropsychologist

Marie R. Faiola, epilepsy coordinator

Janet Scanlon, RN, neurosurgery coordinator


Comprehensive Epilepsy Center office
219 N. Broad Street
Philadelphia, PA 19107-1519

Office: 215-762-7037
Appointments: 215-762-6915

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Hahnemann University Hospital | 230 N Broad St, Philadelphia, PA 19102