Penn offers individualized treatment plans and comprehensive care from a team dedicated to this subspecialty. In addition we collaborate closely with specialists across multiple disciplines throughout Penn Medicine, including:
Neuromodulation therapy utilizes advanced medical devices that work to elevate or suppress activity of the nervous system for the treatment of various diseases that include seizure disorder and epilepsy. These medical devices include:
- Vagus nerve stimulator device
- Responsive neurostimulation device
Neuropsychologists assess patients with seizure disorder and epilepsy to identify and monitor mental, behavioral and emotional symptoms to plan the best treatment. They also provide referral to behavioral therapies to help patients and families better understand and cope with the psychological changes associated with epilepsy.
A multidisciplinary group of about more than a dozen physicians including neurologists and neurosurgeons reviews patient cases and makes a consensus agreement on how to move forward.
For patients with intractable epilepsy, epilepsy that is not cured by medication, and who do not respond to medications, there is a host of surgical options. If surgery is recommended, physicians will discuss the options, risks and benefits to the patients and their families so they can make an informed decision.
Penn neurosurgeons are uniquely qualified to perform epilepsy surgery. Surgical treatment involves identifying and removing the tissue that is causing seizures without damaging normal function.
Types of epilepsy surgery include:
- Vagal nerve stimulator (VNS) is a minimally invasive procedure that improves mood as well as seizure control. It is done as an outpatient procedure and the device resembles a cardiac pacemaker. VNS reduces the seizure frequency by about 60% in about 2/3 of patients.
- Aspire, a newer model of VNS has a cardiac sensor built into it. It fits in the chest like a pacemaker. It can detect when you are having a seizure because of the increase of heart rate. It turns out that 80% of seizures are preceded by elevation of heart rate. The VNS can detect that and quiet down the seizure. This device is good for people who have seizures during sleep.
- Resection, which is removal of the seizure site, is a traditional type of surgery chosen for select cases. For those individuals who have temporal lobe epilepsy, Penn neurosurgeons remove the temporal lobe through traditional surgery or craniotomy. As in many surgical procedures, there are side effects from a resection and it requires an inpatient stay.
- Transorbital Endoscopic Amygdalectomy, TEA, is a procedure Penn invented a few years ago. It uses endoscopes to look into the temporal lobe and remove the part that is causing the seizures without having to perform a craniotomy.
- Responsive Neurostimulation (RNS) is a procedure for more than one seizure site, or seizures that are not in a safe location to remove or ablate. RNS is a medical device that gets implanted. There are tiny electrodes that listen to the brain and when they detect a seizure, it then stimulates that area of the brain like a fire extinguisher preventing a fire from spreading. It triggers anytime a patient is having a seizure. Recently FDA-approved, Penn has been implanting this device in many patients. Once the device is implanted, the Penn Neurosciences team—including neurologists and neurosurgeons—allows it to collect data for two weeks with no stimulation. Then, data collection continues with an eye toward fine-tuning settings around the spurts of stimulation on seizure patterns. Patients can also collect data at home using their own programmer, which behaves like a mini computer. They then transmit information to their physician via the internet.
- Laser technology called Visualase® MRI-guided laser ablation is a procedure that uses a laser beam to pinpoint the problem area of the brain that may be causing seizures. Visualase is a less invasive way to treat temporal lobe epilepsy, which is the most common type of epilepsy in adults. The laser cauterizes the disease part of the brain and surgeons then close the incision with a single absorbable suture.
Download the Penn Epilepsy Surgery Guide to learn more about epilepsy surgical options, the Penn treatment team, and to help determine if surgery is the right option for you.
Research and Clinical Trials
The Penn Epilepsy Center is known for its premier clinical research. Penn is developing biomarkers and new diagnostic tests — including neuromodulation development, surgeries, and devices for the treatment of epilepsy. We are proud to be one of the most innovative centers in the world that leads in basic science and novel therapies.
We offer patients the opportunity to participate in a range of clinical trials including:
- Advanced imaging
- Medications specifically for the treatment of seizure clusters
- New seizure notification devices
- New techniques for EEG monitoring and surgery
- New medications
Penn Epilepsy Center is currently investigating the following:
- Finding hidden seizures—Penn researchers are aiming to find seizure sites when imaging does not pick them up; this study is mainly for medication-resistant patients.
- Brain performance—Penn is conducting studies to enhance brain performance by allowing a patient to move computer cursers by just thinking about it without moving their hands.
Read more about Research and Clinical Trials: