Comprehensive Adult and Pediatric Epilepsy Treatment Center

Board-Certified Neurologists and Neurosurgeons

The Adult and Pediatric Comprehensive Epilepsy Centers at The Department of Neurosurgery at Rutgers Health and RWJBarnabas Health has a nationally-renowned, multidisciplinary team working together to give patients of all ages the attention and medical treatment they deserve.

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The Most Advanced Epilepsy Diagnosis and Treatment

Our team of board-certified neurologists, neurosurgeons and radiologists are accredited as a Level 4 Epilepsy Center by the National Association of Epilepsy Centers (NAEC) for providing the most specialized care, according to the Guidelines for Essential Services, Personnel, and Facilities in Specialized Epilepsy Centers in the United States.

Fourth level epilepsy centers must meet exacting standards and provide comprehensive services, including a broad range of surgical procedures. That means our patients have the best possible epilepsy treatment team from our highly-specialized team of board-certified physicians. NAEC recommends patients see a level 3 or 4 epilepsy treatment center if epileptic seizures have not been under control after 3 months of medical supervision by a primary care provider, and especially if they see no or minimal improvement after 12 months of care by a general neurologist. Delayed care can be detrimental to the patient’s health and safety, as well as their quality of life.

What Is Epilepsy?

Epilepsy is a neurological disorder causing repeated, unpredictable seizures because of electrical disturbances in the brain. Although many people associate epilepsy with wild convulsions of the body, this is not true for every person who experiences epileptic seizures. Instead, most seizures are not nearly as dramatic as those portrayed on TV and in movies, so they can easily go unrecognized to the untrained eye. There are 30 different types of seizures, all with a wide variety of symptoms. Some are mild and do not involve convulsions at all, making it difficult to recognize the seizure while it occurs. However, usually those who experience seizures will have similar symptoms for every episode, making them easier to detect over time.

While anyone can have a seizure, typically one seizure alone is not an indication that the person has epilepsy. Furthermore, seizures are not exclusive to epilepsy; in fact, they can happen for a wide variety of reasons unrelated to the disorder. However, experiencing one seizure is cause for concern and enough reason to visit your physician to determine the root cause.

Some of the most common symptoms of a seizure include:

  • Staring spells
  • A brief blackout and period of confusion
  • Uncontrollable muscle spasms and twitching of the arms and legs
  • Loss of awareness or consciousness
  • Behavioral changes, such as inexplicable fear or a sense of “déjà vu”
  • Drooling
  • Strange tastes, such as a metallic or bitter flavor
  • Clenching of the teeth

Those who have epilepsy can sometimes predict when a seizure will occur if they start to experience dizziness, nausea, unexplained anxiety, and visual symptoms such as flashing bright lights.

Who Is at Risk for Epilepsy?

This seizure disorder affects men and women of all ages, races and backgrounds. There is currently no known cause of epilepsy for at least half of the people diagnosed with it. Those who may be at the highest risk, apart from those who have a genetic influence, include people who experience the following:

  • Head trauma
  • Brain conditions
  • Infectious diseases
  • Prenatal injuries
  • Developmental disorders

According to the World Health Organization (WHO), about 50 million people worldwide suffer from epilepsy, and one in 10 people will experience at least one seizure in their lifetime. In the United States, epilepsy affects 3.4 million Americans, per the Centers for Disease Control and Prevention (CDC), according to 2017 data. Because these organizations estimate that 10% of people will have at least one seizure during their lifetime, it is a prevalent problem, and those diagnosed with epilepsy must follow careful treatment plans to successfully combat this disorder.

Epilepsy can cause numerous challenges, from limitations in career fields to difficulty accessing adequate medical care.

How Is Epilepsy Diagnosed?

If you suspect you could have epilepsy, your doctor will ask you about your symptoms and the nature of the seizure(s) you think you’ve had. Your doctor will also ask if you have experienced any unusual feelings or sensations prior to the seizure and ask for a description of the seizure itself. If you were unconscious during your seizure, it’s worth considering bringing someone with you to your consultation who can more accurately describe what they saw, and how you behaved before, during, and after the suspected seizure.

Your doctor will do a thorough review of your medical history, as well as order any relevant tests. A neurological exam is performed to check for and rule out any other conditions commonly mistaken for epilepsy. The purpose of a neurological exam is to test how well the brain and nervous system function. A common neurological test is when a doctor taps the knee with a hammer to see if you jump. Other neurological tests include checking muscle function, reflexes and looking for problems with coordination.

Tests your doctor may use to determine any brain abnormalities include:

  • Electroencephalogram (EEG): This test looks for changes in the electrical patterns in the brain.
  • Neuroimaging tests: Your doctor may order a computed tomography (CT) or a magnetic resonance imagining (MRI) scan to look for abnormalities in the brain, and to check for a possible brain tumor, which will rule out epilepsy. Other less common neuroimaging tests include single-photon emission computed tomography (SPECT), positron emission tomography (PET), magnetoencephalography (MEG), and others.
  • Other tests: You may also be asked to do a lumbar puncture (spinal tap) test, electrocardiogram (EKG), or a sleep test.

Even if the results appear normal for any or all of these tests, it does not mean you have not experienced seizures or that you do not have epilepsy.

Types of Seizures

There are at least 30 types of seizures, many of which look very different from those portrayed on TV and in movies when characters fall to the floor without warning and convulse uncontrollably (the “classic” seizure is called a tonic-clonic seizure, previously known as a “grand mal” seizure).

Seizures types are divided into two main categories: focal (partial) or generalized.

Focal Seizures

Also called partial seizures, these occur when seizure activity occurs in only one brain hemisphere. There are two main subtypes: focal seizures with retained awareness, and focal seizures with a loss of awareness. Those who have focal seizures are sometimes aware and alert during the beginning of their episode and remember it afterwards, and then lose awareness during the seizure. Symptoms prior to the seizure can include gastrointestinal distress, including possible nausea, burping, flatulence, and vomiting. The person may also turn pallid or flushed, sweat, their pupils may dilate, and their hair might stand on end. Some patients experience an emotional reaction, usually fear and anxiety, especially if they see or hear things that are not actually there. Those experiencing focal seizures may or may not convulse, and if they do, it usually begins in one area of the body, such as the limbs or trunk, and spreads from there.

Generalized Seizures

This is when both the left and right hemispheres of the brain are active during a seizure. Some of the different types of generalized seizures include:

  • Absence seizures (formerly called petit mal seizures): Those who have absence seizures will experience a loss of consciousness and will not remember their seizure. Absence seizures do not cause body convulsions. These seizures usually begin and end abruptly and the main symptom is an absent stare and loss of muscle control. The person may make repetitive movements such as rhythmic blinking or slight movement or tugging at their clothing. These seizures usually only last between two and ten seconds. They are generally unremarkable to onlookers and, as a result, the sufferer may not be diagnosed for years and continue to have absence seizures. One way to detect an absence seizure is if you think they might only be daydreaming – simply touch the person on the shoulder, and if they respond, they are not having a seizure.
  • Tonic-clonic or convulsive seizures (formerly called grand mal seizures): This type of seizure involves electric discharges that involve the entire brain. The most classic symptom is full-body convulsions that last between one minute to five minutes. Muscles stiffen in the “tonic” phase and the person will fall to the floor. The loss of muscle control may result in the person soiling themselves, biting their own tongue, and drooling or frothing at the mouth. The “clonic” phase involves the alarming jerking and rhythmic twitches of the body. After the convulsions cease, called the “post-ictal state,” the person may be difficult to awaken, and they may be fatigued, confused and disoriented. The post-ictal state can last from a few minutes to several hours. Rarely, the person will experience a post-ictal state for several days, up to two weeks.
  • Atonic seizures, also called drop attacks: These brief seizures typically last less than 15 seconds. They begin in childhood and will continue through adulthood. During the episode, the person will abruptly lose consciousness, collapse to the floor, and then quickly regain consciousness and be able to stand and/or walk again after the seizure is over.
  • Clonic seizures: The body or parts of the body will jerk uncontrollably for a few seconds and up to one minute. These seizures affect people of all ages, as well as infants. The person is not conscious during the seizure, and their seizure may eventually progress to become a tonic-clonic seizure.
  • Tonic seizures: The body, arms or legs become suddenly stiff, and the muscle “tone” (the normal tension of the body while at rest) becomes greatly increased. Usually, tonic seizures occur while a person is sleeping, and last less than 20 seconds. These seizures are most common in people who have Lennox-Gastaut syndrome and may occur in clusters throughout the day.
  • Myoclonic seizures: This seizure causes brief jerks and twitches of a muscle, and typically only lasts up to two seconds. Sometimes many will occur in a brief period. They usually begin in childhood but can happen to people at any age. Because they are so unremarkable to onlookers, usually they are not diagnosed for years. These seizures may be mistaken for normal movements or unusual tremors.

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