More than three million Americans are diagnosed with epilepsy, and roughly a third of them cannot get relief from medications. Drug-resistant epilepsy, also known as refractory or intractable epilepsy, happens when two or more anti-seizure medications aren’t working.
The good news is more treatment options are available. Recently, technological innovations and a focus on less invasive procedures have opened new pathways for treating seizures that don’t respond to medications.
“Being diagnosed with epilepsy can be scary and overwhelming,” says Shervin Rahimpour, MD, an epilepsy neurosurgeon at University of Utah Health. “But now more than ever, new and emerging options can offer hope for patients suffering from refractory seizures.”
Location, Location, Location
To determine the type of epilepsy you have, your doctor will first need to identify where the seizure originates in the brain. There are two main types of seizures:
- Generalized Seizures: These seizures appear to occur in multiple areas or throughout the entire brain, often simultaneously.
- Focal Seizures: These seizures can start in one part of the brain and spread to other areas.
For patients with drug-resistant focal epilepsy, doctors can use a technique called stereo-electroencephalography (SEEG). This involves placing electrodes in the brain to monitor activity and pinpoint the exact source of the seizures. Once they know where the seizures originate, they can offer surgical options to remove, ablate, or stimulate the affected brain tissue.
New Technology, New Hope
Some patients with drug-resistant epilepsy may be required to consult with a neurosurgeon to explore some of the latest surgery options. These include:
- Deep Brain Stimulation (DBS): Electrodes are implanted into the brain to stimulate brain tissue to disrupt oncoming seizures.
- Vagal Nerve Stimulation (VNS): A stimulation device is implanted into the vagus nerve (located in the neck), where electric signals are transmitted to the brain to minimize seizures.
- Responsive Neurostimulation (RNS): A recording device is implanted within the skull, where it senses seizures and sends electrical pulses to prevent them from happening.
- Laser Ablation: Also known as laser interstitial thermal therapy, this less-invasive option uses a targeted laser technology to detect and burn away (ablate) the seizure-causing brain tissue.
Get on the Road to Healing
If medication isn’t working, hope is not lost. Talk with your doctor about next steps and consider getting connected with an epilepsy treatment center. These patient-oriented centers offer a wide range of specialists who can guide you through every stage of your journey—from diagnosis to recovery.
“It’s important for patients to know that they have options for managing their epilepsy,” Rahimpour says. “Naturally, there are fears centered around surgery, but I encourage patients to have a conversation with their doctors so they can feel more comfortable and understand what surgical options may be available.”
