By: Charles Akos Szabo, MD, FAAN, FAES
Department of Neurology at UT Health San Antonio
Epilepsy affects about 1 to 2 percent of people in Texas, and despite being the fourth most common neurological disease, it is associated with the most social stigma. In San Antonio, National Epilepsy Awareness Month kicks off with the “Walk to END Epilepsy.” It is hosted by UT Health’s longtime partner, the Epilepsy Foundation of Central and South Texas, to raise epilepsy awareness and community support, as well as to celebrate the ongoing achievements to improve the lives of people with epilepsy.
National Epilepsy Awareness Month also provides the opportunity to honor people with epilepsy and their caregivers, and to remember the lives lost to SUDEP (sudden unexpected death in epilepsy). It’s a reminder of the challenges faced by the community, scientists, researchers and physicians dedicated to the treatment of epilepsy.
It is an exciting time for epilepsy patients. New surgical treatments have higher success rates and are easier than ever before on the body. The team of specialists at the South Texas Comprehensive Epilepsy Center (STCEC), a Level IV epilepsy program accredited by the National Association of Epilepsy Centers–and a 23-year collaboration of UT Health San Antonio and University Health System (UHS)—is actively engaged in recent developments in epilepsy diagnosis and treatment.
New FDA-approved medications are now available, including perampanel, clobazam, eslicarbazepine, brivaracetam and cannabidiol. Some of these drugs are based on a particular course of action and others are adopted in the hope of providing safer alternatives to earlier anti-seizure regimens.
The evaluation of candidates for surgery, those who have failed two to three anti-seizure medications, has also changed. This is a lengthy process to find the source of the seizures in the brain and reduce risks associated with surgery. Our epilepsy center has adopted less invasive tests for the surgical treatment of epilepsy. Tests, once done by injecting drugs into the brain, are now done with an MRI scan. Placing very small electrodes in the brain now has fewer complications and is much easier to handle.
The most common epilepsy surgery, temporal lobectomy, has been replaced with minimally invasive laser ablation therapy. The skull remains intact in both of these techniques, as the electrodes and probes are inserted through small holes. The skull no longer needs to be temporarily removed. Patients are typically discharged one day after S-EEG electrode removal and laser ablations.
“Responsive neurostimulation” is the use of sensors and electrical pulses to detect, record and stop seizures, providing a non-surgical treatment option. Although it is not a cure, seizures can be reduced up to 70 percent after six years.
In addition, specialized dieticians help with the ketogenic diet, one of the oldest known treatments for epilepsy. This means brain surgeries can now be performed with less risk, epilepsy can be treated with diet and our epilepsy center has more options to improve the lives of people affected by epilepsy.
There are many reasons to celebrate. The best way to learn more about epilepsy and join the celebration is to learn more about epilepsy at the Epilepsy Foundation of Central and South Texas website. To learn more about the new approaches and treatments for difficult-to-control seizures, please visit the South Texas Epilepsy Center website or call 210-450-9700 to make an appointment.
South Texas Comprehensive Epilepsy Center (STCEC)