Diagnosis | Treatment | Our Team

Epilepsy, by definition, is a disorder marked by recurring seizures due to abnormal activity of nerve cells, called neurons, in the brain. There are about 2 million people who have epilepsy in the United States. But you have an advantage many of them do not. You have Geisinger, with the most comprehensive treatment available in the region.

The Epilepsy Center at Geisinger’s Neurosciences Institute provides a multi-disciplinary approach to treating adult and pediatric epilepsy. This medical and surgical program features advanced epilepsy monitoring and deep brain surgical techniques that are helping people lead seizure-free lives.

Geisinger Medical Center is recognized by the National Association of Epilepsy Centers 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.

Understanding Epilepsy

When it comes to epilepsy, the first thing people think is – seizures. However, not everyone who has seizures has epilepsy. Seizures are only a symptom of epilepsy. To best understand epilepsy, it helps to understand the different types of seizures.

There are two categories of seizures – generalized and partial. Generalized seizures are a result of electrical impulses arising from the whole brain.  Types of generalized seizures include:

• Grand-mal seizures – also known as tonic-clonic seizures, patients who suffer from grand-mal seizures lose consciousness and often collapse. The body becomes stiff and begins to involuntarily jerk after which you fall into a deep sleep.
• Petit-mal seizures – also known as absence seizures, patients who suffer from petit-mal seizures lose awareness of their surroundings and stare blankly for a few seconds.
• Myoclonic seizures – this type of seizure causes your body to jerk as if being shocked.
• Clonic seizures – this type of seizure causes both sides of your body to jerk at the same time.
• Tonic seizures – with this type of seizure, your muscles suddenly become stiff.
• Atonic or akinetic seizures – these seizures will cause your muscles to relax, specifically your arms and legs, which often result in a fall.

Partial seizures begin from impulses in a smaller, or isolated, part of the brain. Types of partial seizures include:

• Simple partial seizure – with this type of seizure, you remain conscious but may experience movements like jerking or stiffening.
• Complex partial seizure – similar to a simple partial seizure only your awareness is impared. You may involuntarily walk, chew, fidget or other simple functions, but appear “spaced out”.

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Diagnosis

It’s important for you to get an accurate diagnosis in order to be treated appropriately. Our specially-trained neurologists (called epileptologists) work with a team of specially-trained medical professionals to precisely diagnose your epilepsy and formulate a treatment plan.

In order to determine the best course of action for treating your epilepsy, our staff of physicians will ask you about your medical history.  Some of the questions you can expect include:

• At what age did your seizures start?
• Describe your surroundings when you had your first seizure.
• Have you identified any triggers for your seizures?
• How do you feel during your seizures?
• How long do your seizures last?
• How often do you have seizures?

Depending on the complexity of your epilepsy, you may be scheduled for long term epilepsy monitoring. This test will allow your physicians to monitor you before, during and after a seizure, the results of which are used to develop your treatment plan. Geisinger offers both adult and pediatric long-term EEG monitoring.

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Treatment

At Geisinger’s Epilepsy Center, our pediatric and adult patients benefit from the latest medical and surgical treatment options. Your individualized treatment plan is designed to treat your epilepsy and enable you to live a seizure-free life.

Most seizures can be treated with medication. Your epileptologist will work with you to develop a medication plan suited for your needs.

For those patients who might benefit from surgery, a surgical technique is available to help people with continuous, disruptive seizures. Geisinger neurosurgeons place electrodes into the brain to record seizure activity. This pinpoints the diseased part of the brain, enabling the surgeons to remove only the affected tissue. Healthy surrounding brain tissue is spared.

Other surgical options for the treatment of epilepsy include:

• Vagas nerve stimulation – a surgical treatment where neurosurgeons place a small pacemaker under the skin near the vagal nerve in the side of the neck.  This device regulates electrical activity in the brain and can reduce the frequency and severity of seizures.
• Resective surgery for epilepsy – a surgical procedure that removes the specific area of the brain that is generating the seizures.  Often called a temporal lobectomy, in which the surgeon removes a portion of the temporal lobe, this procedure is the most often performed surgery for epilepsy.

For more information about epilepsy, please visit the National Epilepsy Foundation website.

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Our Team

• Frank Gilliam, MD, Director of Neurology, Epileptolgist
• Matthew Eccher, MD, Epileptologist
• Adil Khan, MD, Epileptologist
• Carol Ulloa, MD, Epileptologist
• Jill Gotoff, MD, Pediatric Neurologist
• Ronald Spiegel, MD, Pediatric Neurologist
• Steven Toms, MD, Director of Neurosurgery, Neurosurgeon
• Joseph Emrich, MD, Functional Neurosurgeon
• Amir Kershenovich, MD, Pediatric Neurosurgeon

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