Intractable
Some individuals with epilepsy cannot be treated satisfactorily with any of the commonly available medications. At the University of Virginia’s F.E. Dreifuss Comprehensive Epilepsy Program these patients may be treated in three ways:
Surgery
The goal of surgery is to remove the location within the brain that causes the seizures. Evaluation for epilepsy surgery is performed in two or three phases. The first phase is hospitalization to locate the site of seizure origin by standard simultaneous video/EEG monitoring.
A second phase may be necessary to further locate the site of seizure origin by invasive methods. The third phase is hospitalization for surgery to remove the site of seizure origin. This may be performed using traditional neurosurgical techniques or the Gamma Knife.
Vagus Nerve Stimulation:
The VNS consists of an electrical wire and a generator. The wire is implanted in the neck and is connected to the vagus nerve at one end. The other end is connected to a generator that is implanted under the skin over the chest. The VNS works in two way: it is set to deliver an electrical charge to the vagus nerve at specific intervals and the patient can activate it if they feel the onset of a seizure. This device is also called a NeuroCybernetic Prosthesis (NCP).
Experimental Drugs and Devices:
These medications may be offered to appropriate patients who want to participate in ongoing clinical trials.