When should I see a GI?

More than three million Americans have epilepsy, a brain disorder that can cause chronic seizures. Epilepsy can be the result of a traumatic brain injury, tumor, stroke, genetic disorder, or other neurological conditions. For many people, the cause is unknown.

People with epilepsy face everyday challenges besides seizures. Many experience depression or anxiety, physical or cognitive problems, and other health conditions. Some may lose their driver’s licenses or struggle with everyday tasks.

“Epilepsy not only causes physical and cognitive problems for patients when they suffer from seizures, but it also robs them of their sense of control,” says Alexus Widmer, PA-C, a physician assistant at the UPMC Comprehensive Epilepsy Center.

The UPMC Comprehensive Epilepsy Center helps people with epilepsy overcome the challenges caused by the disease. Experts in neurology, neurosurgery, radiology, psychology, and psychiatry provide world-class diagnosis and treatment, with the goal of helping patients become seizure free.

“Whether it’s going back to work, getting a license back, or just having a better quality of life, patients are so grateful when they become seizure free,” says Hallie Gilbert, PA-C, a physician assistant in neurology. It can be life-changing for them.”

What to Expect at the UPMC Comprehensive Epilepsy Center

UPMC’s center is designated a Level 4 Epilepsy Center by the National Association of Epilepsy Centers. This classification — the highest level possible — means UPMC offers the most advanced monitoring, testing, treatments, and surgical options for patients with even the most challenging treatment-resistant epilepsy.

UPMC’s center uses a team approach, with multiple medical specialties working together to make care recommendations for patients.

Because the condition is complex, the team approach is crucial.

The UPMC Comprehensive Epilepsy Center offers services that include advanced diagnostics and multiple treatment options that include medicines and surgery for patients who need it.

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Diagnosis at the UPMC Comprehensive Epilepsy Center

Seizures can happen at any age and for many reasons, from genetics to brain injury. To be diagnosed with epilepsy, patients must have had at least two seizures more than 24 hours apart with no known medical conditions or provoking factors as the cause.

Your primary care doctor or a specialist can refer you to the UPMC Comprehensive Epilepsy Center, but you do not need a referral. Call the center at 833-398-0286 to schedule an appointment. The center is located in the Kaufmann Medical Building in Pittsburgh’s Oakland neighborhood, across from UPMC Presbyterian.

On a first visit, you can expect to meet with one of the center’s epileptologists (neurologists who specialize in seizures).

“For patients who have seizures that are difficult to control, an epileptologist often can provide greater insight into their treatment,” says Ms. Widmer. “They are more experienced with medicines, or combinations of medicines, and can begin the process of evaluating appropriate patients for surgical alternatives.”

In addition to an examination and a discussion of your history, the epileptologist may order further tests. These may include an EEG, which looks at your brainwaves, and an MRI, which provides imaging of your brain’s surface and beyond. The tests can help the epileptologist diagnose epilepsy and identify the source of your seizures.

UPMC’s Epilepsy Monitoring Unit

If your tests are inconclusive, you may spend time at UPMC’s Epilepsy Monitoring Unit (EMU). Located at UPMC Presbyterian, the EMU helps the team definitively diagnose and pinpoint where in your brain seizures are coming from.

Stays at the EMU typically last three to seven days. You will stay in a video-recorded private hospital room while connected to an EEG that monitors your brain activity and physical symptoms.

If necessary, your antiseizure medicine may be reduced to make a seizure more likely. Our care team will monitor you at all times and is trained to respond immediately when a seizure occurs.

“The goal of the EMU is to capture seizures in the safest environment possible,” says Ms. Gilbert. “If seizures are seen on EEG, we can better understand the type of seizure a patient has, which allows for more treatment options.”

Treatment at UPMC

Treatment for epilepsy usually begins with medicine.

There are more than 25 different medicines to treat epilepsy. The type of seizure you have, and factors like age, gender, and medicine side effects, will determine the type of medicine your doctor prescribes.

Medicine can control seizures for about two out of three epilepsy patients.

Surgery for Patients at UPMC

About one-third of epilepsy patients can’t control their seizures with medicine. If you have tried multiple medicines that don’t stop your seizures, our doctors may recommend an evaluation for surgery.

The purpose of this surgery is to identify and remove or adjust the part of the brain that is causing seizures. The goal is to reduce your seizures or stop them altogether. The ultimate goal of epilepsy surgery is freedom from seizures.

A full list and description of surgical options can be found on the center’s website.

For more information about the UPMC Comprehensive Epilepsy Center or to schedule an appointment, call 833-398-0286 or visit us online.

About Neurosurgery

The UPMC Department of Neurosurgery is the largest academic neurosurgical provider in the United States. We treat conditions of the brain, skull base, spine, and nerves, including the most complex disorders. We perform more than 11,000 procedures each year, making our team one of the most experienced in the world. Whether your condition requires surgery or not, we strive to provide the most advanced, complete care possible. Our surgeons are developing new techniques and tools, including minimally invasive treatments. Find an expert near you.