On National Epilepsy Day, November 17, 2023, Dr Rima Chaudhari, Senior Consultant – Neurology, Fortis Hospital, Mulund explains the role of Video EEG’ in managing Epilepsy patients
Epilepsy is a neurological condition that leads to unprovoked, recurrent seizures. A seizure is a sudden rush of abnormal electrical activity in the brain. In most cases, a person is diagnosed with Epilepsy when they have two or more seizures with no other identifiable cause.
Epilepsy can vary significantly from person to person, so treatment plans may need to be customized according to specific requirements. In this regard, ‘Video EEG’ plays a significant role, but before understanding its role in managing Epilepsy patients, let’s know how this condition is treated.
How is Epilepsy treated?
The main goal of any treatment plan for Epilepsy is to ensure that the number of seizures experienced by the person decreases and, in the best-case scenario, stops completely. For this, the following methods are employed:
- Anti-epileptic drugs can reduce the number of seizures experienced by the person. In some cases, these drugs may eliminate seizures
- The ‘vagus nerve stimulator’ is surgically placed under the skin on the chest, which electrically stimulates the nerve that runs through the neck to prevent seizures
- According to the Epilepsy Foundation, children who do not respond to medications or drugs can sometimes benefit from a ketogenic diet, which is a high-fat and low-carbohydrate diet
- In some cases, brain surgery involving the area of the brain that causes seizure activity can be removed or altered
How does Video EEG help in the management of Epilepsy patients?
A Video EEG (Electroencephalograph) records what a patient is doing or experiencing on videotape, while an EEG test records the brainwaves. This is a highly specialized test done only at a few centres and is typically managed by an Epileptologist.
The purpose of an EEG is to enable specialists to see what happens when a patient has a seizure or event and compare the picture to what the EEG records simultaneously. It allows a specialist to have a clearer picture:
- Whether the patient experienced any seizures
- Where the seizures originate in the brain
- The correct number of medications to prescribe to the patient based on the seizures they suffered
This test forms the backbone of Epilepsy surgery evaluation. It helps specialists evaluate whether the medications being prescribed to an Epilepsy patient are correct or whether they need another form of treatment. For instance, one patient underwent EEG monitoring, during which the specialists realised that medications were not the right approach for him. Instead, they focused on decreasing his medications and started counselling, which had a far more positive outcome.
In another case, there was a patient who had a complex history of feeling a sense of repeated urge to urinate and who was deemed to have Stress and Anxiety. On monitoring him during these symptoms, it turned out that he had seizures on the EEG coming from the temporal lobe of the brain, which can produce these symptoms. The patient was then treated for the same and is now symptom-free.
Is there a cure for Epilepsy?
Early treatment with medication can help reduce the frequency of seizures, and the chances of severe complications in the possible future.
However, at the time being, there is no cure for the condition, although proper treatment can result in a dramatic improvement in a patient’s condition and ensure that their quality of life is not impacted.