When multiple medications fail to control the seizures, patients are referred to a level three or four epilepsy center. The Cedars-Sinai Epilepsy Program is designated as a level- four center, the highest rating indicative of a medical and surgical program rated by the National Association of Epilepsy Centers (NAEC). A level- four center provides highly specialized evaluation, treatment and management of patients with intractable seizures and offers surgical intervention.
Other types of patients admitted to the Epilepsy Monitoring Unit are patients suspected of having non-epileptic events or pseudo seizures, new onset seizure disorder, cardiac episodes and patients with a history of febrile seizures as small infants. About 30 percent of patients are evaluated to differentiate non-epileptic from epileptic seizures. Long-term video EEG monitoring is required to differentiate between non-epileptics and epileptic events. Non-epileptic events are caused by psychological reasons and not by an abnormality in the brain. By capturing the seizures in question both on EEG and video, the epilepsy team is able to determine whether the events are epileptic.
Common questions asked by patients and experts include:
- Will the seizure respond well to medication?
- Does the seizure begin in a localized or discrete area of the brain?
- Does it begin in one area or does it arise from both sides of the brain?
- Are all the seizures the same?
- Do they have the same clinical and brain-wave pattern characteristics?
- Do the seizures originate from the right or left hemisphere of the brain?
These are all valid and critical questions. The answers may offer a variety of treatment courses, including medication or, if necessary, surgery.
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