By Lori DeBoer
Mayo Clinic physicians have access to some of the most innovative and successful treatments available for patients with seizure disorders, ranging from nerve stimulation to surgery.
Many seizure disorders are subtle and are more difficult to diagnose than the grand mal seizures typically associated with epilepsy, according to Dr. Joseph Sirven, a Mayo Clinic neurologist who specializes in epilepsy. The majority of these disorders are treatable with a recent array of anti-seizure medications, with two new ones being introduced soon.
Patients who do not respond to pharmaceutical therapies are likely candidates for vagal nerve stimulation. The vagus nerve is stimulated by a small electric discharge from electrodes surgically implanted in the neck. Dr. Sirven is the lead author in a recent multicenter trial of the device in older adults.
Surgery is an option for patients who have complex partial seizures, including episodes of confusion, says Dr. Kathryn Hirschorn, a Mayo Clinic neurologist who specializes in seizure disorders. A temporal lobectomy to remove the seizure-causing section of the brain can help control seizures and improve cognitive functioning.
Patients who are unable to undergo surgery may respond to a ketogenic diet, which was developed by Mayo Clinic in the 1920s. The high-fat, low protein, no carbohydrate diet must be supervised by a physician, but has had a success rate of approximately 50 percent. Hormone therapy for female epilepsy patients is also under investigation.
Clinical Tip: Senior citizens with mild seizure disorders may be misdiagnosed as having senile dementia or Alzheimer’s Disease.
