Epilepsy: Very Common, Rarely Discussed

Though it is the fourth-most-common neurological disorder and, according to the Centers for Disease Control and Prevention (CDC), affects 65 million people worldwide, epilepsy seems to exist somewhat under the radar—that is, unless you or someone you love suffer from its often daunting symptoms. We asked four area physicians who specialize in the treatment of epilepsy and other neurological disorders to help explain some of the many facets of the disorder. 

What, exactly, is epilepsy? 

“Epilepsy is a brain disease in which a person is predisposed to recurrent seizures. It is diagnosed if a person has had two or more unprovoked seizures in their lifetime,” says Olgica Laban-Grant, MD, co-director of White Plains Hospital Seizure Diagnostic Center  (the only Level 4 specialized epilepsy center in the area) and associate director of the Northeast Regional Epilepsy Group. “However, the International League Against Epilepsy is considering a new definition, in which a person may be diagnosed with epilepsy even if one unprovoked seizure occurs but there is a high chance of a recurrence based on an EEG and epilepsy syndrome.” 

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Are there different types of epilepsy and how is the condition diagnosed? 

“There are many different types of seizures and epilepsy,” says Marcelo E. Lancman, MD,
co-director of the Seizure Diagnostic Center at WPH. According to Laban-Grant, “an EEG test [which records brain waves] is the ‘gold standard’ for the diagnosis of epilepsy.” 

Does epilepsy develop in different ways?

“Overall, the most common causes of epilepsy are head trauma, stroke, brain tumor, and brain infection,” says Lancman. “However, in 60 to 70 percent of patients, the cause remains unknown.” 

What do you think is most misunderstood about epilepsy? 

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“One common myth is that people with epilepsy are disabled,” says Lancman. “Many people with epilepsy live fulfilling lives and are highly accomplished.” 

What is the standard treatment protocol for epilepsy?

 “Anti-seizure medications are the primary treatment to control seizures,” says Laban-Grant. “Up to 70 percent of people respond well to treatment with medications, but this depends on the type and the cause of epilepsy. Dietary therapies, such as a ketogenic diet and a modified Atkins diet, are used in certain difficult cases to control epilepsy syndromes.”  

According to Arno H. Fried, MD, FACS, FAANS, a neurosurgeon on the White Plains Hospital epilepsy team, “Epilepsy surgery is considered when medications fail to satisfactorily control seizures and the area of seizure onset in the brain can be safely removed. In carefully selected cases, surgery may be curative.”

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