Advanced Epilepsy Care: The Brain Is a Complicated Machine

Living with epilepsy can be challenging for both patients and their loved ones. Seizures can occur anytime, anywhere, and often without warning — all triggered by a brief moment of abnormal brain activity.

Epilepsy affects about 1% of the U.S. population primarily in two age groups: young children who develop the disease from birth or genetics and adults over age 65 whose brains have changed over time (most commonly due to vascular disease, causing small strokes and microscopic brain injury).

For both age groups, teams of researchers, neurosurgeons, subspecialists and their neuro-therapeutic advancements, are all contributing to improved outcomes and cures, for those with this debilitating disorder.

A Nationally Accredited Level 4 Epilepsy Center

“For people who are suffering from epileptic seizures, we have so many tools today that will allow them to lead normal and productive lives,” says neurologist Stephen Wong, MD, Atlantic Health System’s new director of epilepsy. He is excited about the future of this rapidly unfolding field of medicine.

“Atlantic Health System has achieved the highest level of accreditation for neurological excellence from the National Association of Epilepsy Centers (NAEC). We’re one of only a few level-4 epilepsy centers in New Jersey, which means we offer the most complex forms of intensive neurodiagnostic monitoring paired with resective surgery, device implantation, and laser ablation options.”

This national recognition comes with an abundance of technology and talent that allows Atlantic Health System to deliver profound and life-changing outcomes for patients and families. Here are a few technologies that are key to the epilepsy center’s success.

Tools That Help Our Physicians Detect a Seizure’s Origin

MEG®, (magneto encephalography) is a noninvasive therapy used to study epilepsy and brain function. The machine uses 300 sensors to localize epileptic activity — and is the one of only in New Jersey that is available for clinical use. MEG is an essential diagnostic tool that guides neurosurgeons to pinpoint accuracy in placing electrodes for surgery.

“Used in conjunction with electroencephalogram (EEG), which measures electrical activity in the brain, and magnetic resonance imaging (MRI), which provides a detailed image of the brain, surgeons can gain a more precise understanding of the location of the seizure onset and surgically remove only the faulty tissue,” says Dr. Wong.

The ROSA One® Brain Robot is a minimally invasive robot-assisted tool that shrinks procedure time and increases accuracy using a robotic arm. The neurosurgeon-assisted robot places electrodes inside of the head to localize the seizure site. Then it helps the neurosurgeon remove affected brain tissue with precision and accuracy.

“We use this technique in conjunction with an intercranial EEG, which places the electrodes directly in the brain to achieve the best and most accurate information. It is more comfortable for our patients and better tolerated than traditional invasive EEG methods that require a craniotomy,” says Dr. Wong. “Once we determine where the seizure is coming from, we have a clear and straightforward surgical path.”

Surgical Solutions and Teamwork Set Us Apart

Before any surgery is performed, the neurologist must determine if the seizures are focal, meaning they’re localized in one area of the brain, or generalized, meaning they affect the entire brain.

In 95% of the cases, medications cure both focal and generalized seizures. But for the small percentage of people who are surgical candidates with localized seizures, a neurosurgeon and a team of specialists work with robotics to delicately remove only the affected brain tissue.

Another advanced surgical procedure, known as laser ablation, involves inserting a fiberoptic cable stereotactically through a small hole in the brain to destroy the epileptic tissue that is causing the seizure using laser light and heat.

Using Neurostimulation to Suppress Seizures

Patients who are nonsurgical candidates or resistant to medications may benefit from an implantable device that places electrodes inside the body to change how the nervous system works.

These implantables, such as the vagus nerve stimulator (VNS), responsive neurostimulator (RNS) or deep brain stimulator (DBS), are all proven options to suppress seizures. They combat the neurotransmitter’s seizure signal to the brain, averting the seizure.

Curing Epileptic Seizures

“It is interesting to understand how we’re made, built and function,” says Dr. Wong. “The longer I am in this field, the more I value the relationships I’ve built with my patients over time. I have enjoyed learning about them through long-term management of their seizures. Unlike many other fields of neurology, we can cure people and return them back to their normal function. It’s why I love this field of medicine.”