Symptoms

Seizures come in various shapes and sizes – some are quiet staring spells, while others can cause a person to collapse, shake, and become unaware of what’s going on around them. It’s important to remember that having one seizure doesn't mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis.

Seizure symptoms can include:

• Staring spells
• Uncontrollable jerking movements of the arms and legs
• Loss of consciousness/awareness
• Fear, anxiety or feelings of déjà vu
• Brief changes in neurological function, such as in speech or vision

Diagnostics and Testing

Each of our patients undergoes a thorough evaluation and a comprehensive diagnostic work up. At Ochsner, we use cutting-edge technology:

• Video EEG (electroencephalogram) monitoring
• Home extended EEG monitoring (with and without video recording)
• Pharmacological and non-pharmacological activation procedures to provoke seizures and seizure-like events
• Transcranial doppler
• Tilt-table study
• Intracranial EEG monitoring with subdural electrodes, depth electrodes and stereo-electroencephalogram (sEEG) approach
• T3 brain MRI (magnetic resonance imaging)
• Functional brain MRI
• Brain PET (positron emission tomography) scan
• Ictal SPECT (single photon emission computed tomography) scan
• DTI (diffusion tensor imaging) MRI
• Wada test

Conditions Treated

Ochsner’s epilepsy experts specialize in providing a wide range of cutting-edge treatments for adult and pediatric conditions, including:

• Seizure disorders in adults, children, pregnant women, and seniors
• Lennox-Gastaut syndrome and other epileptic syndromes
• Patients with refractory focal epilepsies who may benefit from epilepsy surgery
• Non-epileptic events
• Autoimmune encephalopathy that cause seizures
• Status epilepticus

Epilepsy Monitoring Unit (EMU)

Ochsner is the only institution in Louisiana that operates an epilepsy monitoring unit (EMU) where patients with complex seizure disorders and other repetitive neurological events can be diagnosed and managed. Monitoring in the EMU provides a detailed analysis of brain activity and other physiological measurements over multiple days.

Adult and pediatric services: The EMU at Ochsner has eight dedicated adult beds and two dedicated pediatric beds with capacity to expand services to other telemetry beds in the hospital. The EMU rooms have special safety measures, and some are equipped with dual cameras. Our team of epileptologists, nurses, intensivists, and EEG technologists track and record brain activity 24 hours a day. Patients are monitored closely to ensure safety during their stay.

For Patients

Download the information regarding your diagnostic study in the EMU.

Adult and Pediatric Epilepsy Surgery Evaluations

Did you know that patients with epilepsy are candidates for surgery after trying at least two anti-seizure medications at appropriate dosages that fail to control the seizures?

We offer surgical evaluation and planning with various testing modalities including:

Phase I: Brain positron emission tomography (PET), epilepsy protocol brain magnetic resonance imaging (MRI), functional brain MRI studies, ictal SPECT (single photon emission computed tomography) scans, diffusion tensor brain MRI, Wada testing, neuro-psychological testing and video EEG monitoring

Phase II: Intracranial video EEG monitoring, functional mapping and seizure localization, and neurostimulation

Surgical options for treatment include:

• Laser ablation
• Open resection
• Neuromodulation (responsive neurostimulation, deep brain stimulation, vagal nerve stimulation)

Our team hosts weekly multi-disciplinary surgical case conferences, where patients and their family members are involved in the decision-making process leading up to and during surgery. Our dedicated nurse and social worker help navigate patients through this process.

Special Programs and Services

Neuro-Intensive Care Unit

Patients are cared for by expert neuro-intensivists who work in collaboration with our epileptologists to provide dedicated care to patients with life-threatening seizures and status epilepticus. We offer several advanced therapeutic options and clinical trials for these critically ill patients. The Neuro ICU is one of the largest in the country with 45 beds.

First Seizure Clinic

Ochsner provides an expedited access to patients experiencing their first seizure or seizure-like event that requires a thorough evaluation.

Epilepsy During Pregnancy

Our team understands that the needs of patients with epilepsy are different during pregnancy. Our epileptologists are trained in pharmacological management of epilepsy during pregnancy and the postpartum period. We will collaborate with your obstetricians to make sure you and your baby are getting the very best care.

Our program collaborates with a national pregnancy database for patients with epilepsy to monitor outcomes in babies. Learn more: http://www.aedpregnancyregistry.org

Transition Epilepsy Clinic

Ochsner provides a seamless transition for adolescents transitioning to adulthood that need care for their epilepsy. The pediatric and adult neurologists work together as a team, along with the social worker, to ensure that the care is uninterrupted and appropriate.

Treatments Offered

Ochsner offers several options for the management Epilepsy:

1. Pharmacological therapies and drug monitoring
2. Vitamin therapy
3. Dietary therapies (ketogenic diet)
4. Management of mood and cognitive co-morbidities
5. Physical and occupational therapy
6. Behavioral therapy (cognitive behavioral therapy, psychotherapy, counseling)

We also offer the following surgical treatments:

Resective surgery: The neurosurgeon will temporarily remove part of the bone from the skull to expose the brain. This surgery involves the removal of the seizure focus (brain tissue responsible for the generation of seizures). The extent of the resection varies based on the results of diagnostic testing for each patient.

Vagal nerve stimulation (VNS®): This therapy is designed to prevent seizures by sending regular, mild pulses of electrical energy to the brain via the vagus nerve. These pulses are supplied by a device placed in the chest that is similar to a pacemaker. Some models of VNS can detect rapid rise in heart rate associated with some seizures and deliver stimulation targeted at aborting the seizure. The surgical procedure involves implanting this device into the chest region and the electrodes in the neck region. This surgery typically does not require the patient to be admitted to the hospital, nor is localization required.

Responsive neurostimulation (RNS®): Ochsner is the only facility in the region offering the RNS® System. This device automatically monitors brain signals and provides stimulation to abort seizures. The system is intended for adults with medically refractory partial seizures that come from one or two areas in the brain. It is particularly useful for seizures coming from eloquent parts of the brain, such as those responsible for speech or movement. The device also has the capability of targeting broad areas in the brain where seizures originate. The surgical procedure involves implanting this device into the brain and skull. The surgery typically requires the patient to be admitted to the hospital for a brief recovery period.

MRI-guided laser ablation: Ochsner is the only institution in the region to use MRI-guided laser ablation technology for minimally invasive neurosurgery. This allows us to use a laser to burn precise portions of the brain to stop seizures. The surgical procedure involves implanting a thin laser into the brain. The patient is monitored continuously in the MRI scanner while the procedure occurs. The surgery typically requires the patient to be admitted to the hospital for a brief recovery period.

Deep brain stimulation (DBS) for epilepsy: The newest surgical treatment for epilepsy, DBS has two electrodes placed in the anterior nuclei of the thalamus and connected to a pacemaker-like generator in the chest. This is a suitable option for patients whose seizure-onset zone cannot be localized more precisely. The surgery typically requires the patient to be admitted to the hospital for a brief recovery period.

For more information on these treatment options, visit the Epilepsy Foundation.

Causes of a Seizure

Epilepsy is caused by irregular brain activity. It affects patients of all ages, races and ethnic backgrounds.

• A birth defect in the structure of the brain
• A head injury
• A tumor
• A stroke
• An infection

Sometimes no clear cause of seizures can be identified.

Clinical Research

Ochsner Neurosciences participated in several investigator initiated and national clinical trials not widely available. Our epileptologists, neuro-intensivists, neuropsychologists, and neurosurgeons are actively engaged in research and present their work at several national and international scientific meetings. Learn more about Clinical Research at Ochsner.

Educational Programs

• Our team is committed to education and training through various programs
• The Ochsner neurology department hosts an APPCN-accredited adult neuropsychology residency program
• The Ochsner neurology department hosts an ACGME-accredited adult neurology residency program
• We also have a shared ACGME-accredited neurosurgery residency program with Tulane University
• Ochsner Neuroscience Institute is a training site for residents in neurosurgery and neurology from Ochsner, Tulane and Louisiana State University residency programs
• Ochsner Neuroscience Institute is a training site for medical students from University of Queensland/Ochsner clinical school, Tulane University and Louisiana State University
• Ochsner hosts an EEG fellowship program accredited through The American Board of Clinical Neurophysiology for neurologists
• Ochsner Epilepsy Program serves as a site for clinical observership for international physicians interested in learning more about advanced epilepsy care
• Ochsner Neuroscience Institute is an accredited training site for neurodiagnostic technologists programs

For Referring Physicians

To refer a patient, call the Clinic Concierge at 504-842-7436 or 1-855-312-4190.

• The Clinic Concierge assists with getting copies of patient records and scheduling clinic appointments.
• The Clinic Concierge team can also capture your preference for receiving post visit follow-up from the patient's appointment.