Globally, there are more than 50 million people living with epilepsy – with 80 percent living in low-to-middle class income countries, and 75 percent without treatment, according to the World Health Organization. While causes remain mostly unknown, possible causes can include neurological infection, stroke, genetics and pre-natal brain damage. Most patients with epilepsy can be effectively managed with drug therapy. However, about one-third of epilepsy patients require more than standard medical therapy, necessitating more sophisticated diagnostic and treatment services. If medications do not adequately control a patient’s seizures, surgery may become a treatment option.
As technologies continue to advance, so do the surgical techniques that can be provided. For example, an innovative stereotactic robot is now expanding epilepsy surgery options, even to those previously considered inoperable. Much like a "GPS" for the brain, the stereotactic robot can be used for neurological procedures requiring surgical planning with preoperative data, patient registration, precise positioning and handling of instruments. The system’s arm is designed to perform surgery with extremely small instruments, often as thin as a needle. Its range of motion and ability to assume different positions, allow for accuracy, as well as quicker recovery for patients. Cleveland Clinic is currently the only medical facility in South Florida offering the stereotactic robot as a surgical option for epilepsy treatment.
For epilepsy patients with seizures that are not well controlled by medications, Cleveland Clinic offers another advanced treatment option – responsive neurostimulation – where a small device is implanted in the skull. This device monitors brain activity and delivers short electrical pulses to terminate seizure activity. Types of stimulation include deep brain, intracranial cortical, and vagal nerve. The clinic is also the only facility in South Florida offering SEEG (Stereoelectroencephalography) for uncontrollable epileptic seizures, a procedure first launched by Cleveland Clinic in 2009, where doctors use the stereotactic robot to place electrodes in targeted brain areas, which are then monitored to precisely locate the seizure source. Specialists then review the data and determine what the best treatment can be, such as surgery.
Epileptologists use video EEG monitoring (electroencephalography) to not only diagnose a seizure problem accurately, but also to design the best possible treatment plan. The EEG data also may be combined with the latest in noninvasive testing to determine a patient’s candidacy for epilepsy surgery – such as High-quality 3-Tesla magnetic resonance imaging (3T-MRI), Single-photon emission computed tomography (Ictal SPECT), which helps to localize the area of the brain where seizures originate and Magnetoencephalography (MEG), which maps brain activity by recording magnetic fields generated by electrical activity in the brain.
Cleveland Clinic Florida’s Epilepsy Center offers the latest in medical, surgical and interventional treatments, providing the most comprehensive, advanced care for adults and adolescents. Cleveland Clinic’s multidisciplinary team includes three board certified Epileptologists and an Epilepsy Neurosurgeon, who collaborate with other specialists in areas such as Oncology, Radiotherapy, and Spine disorders – at both Cleveland Clinic Centers located in Weston, Florida and Cleveland, Ohio – to offer patients the highest level of specialized recommendations and care. Recently, Cleveland Clinic Florida’s Epilepsy Center was accredited by the National Association of Epilepsy Centers (NAEC) as a Level 4 epilepsy center. Level 4 epilepsy centers have the professional expertise and facilities to provide the highest level medical and surgical evaluation and treatment for patients with complex epilepsy.
To learn more on Epilepsy and the Epilepsy Center, visit Cleveland Clinic Florida online.
Diane Phillip & Associates
