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Summary & Participants

Join our panel of experts as they discuss various standard treatment strategies for epilepsy and the factors doctors and patients should consider as they make decisions about their treatment.

Medically Reviewed On: May 07, 2008

Webcast Transcript

DAVID FOLK THOMAS: Welcome to our webcast. I'm David Folk Thomas. The topic is epilepsy and, more specifically,the treatment of epilepsy. Over 2 million Americans have been diagnosedwith this disease, but the good news is that 80% of people can have their seizures controlled with medication. We're going to get into thevarious treatments for epilepsy.

Joining me, to give us the lowdown on all of this, to my left is Dr.Carl W. Bazil. He's an assistant professor of neurology at Columbia University. Next to Dr. Bazil is Dr. Sue Herman. She's alsoan assistant professor of neurology, but not at Columbia. She's atSUNY Downstate Medical Center in Brooklyn. They're both here, inNew York. Welcome, doctors. Sue, let me start with you. Can all epilepsies, just very briefly, what is epilepsy? And canthey all be treated with drugs?

SUSAN T. HERMAN, MD: Epilepsy is a disease that is characterizedby seizures, which are recurrent episodes of abnormal activity in the brain. We're probably most familiar with grand mal seizures, where people falldown and shake all over. Most people can have their seizures adequatelycontrolled with medications. Nearly 80% of patients can have no seizureson anti-epileptic medications.

DAVID FOLK THOMAS: What kind of medications are we talking about? Pills, what form, Dr. Bazil?

CARL W. BAZIL, MD, PhD: The medications that we use are all insome sort of pill or capsule, oral form. At least, for the outpatient. In the hospital and so forth, we sometimes use intravenous drugs. But what we're really talking about is pills and oral medications.

DAVID FOLK THOMAS: Sue, how do you know, if you have a seizure,how does the doctor begin to figure out what you have and what you need?

SUSAN T. HERMAN, MD: The first thing we need to do is get a gooddescription of what happened, from the patient or from somebody who sawthe seizure. That helps us to decide what kind of seizure it wasand whether or not it actually was a seizure. There are many otherthings that can sometimes be confused with seizures.

But once we've decided that it is a seizure, then we would do someother testing to determine what kind of seizure it is. We can doan electroencephalogram, which is a test of the brain wave activity. We can do a CAT scan or an MRI of the brain to look and see if there'sany abnormalities, if the person had had a stroke before or head trauma,to get a better idea of what kind of seizure they have and what their riskof having another seizure is.

DAVID FOLK THOMAS: If, say, somebody has had a seizure, or they'rediagnosed with epilepsy, give us examples, then, of what some of the diagnosesmight be, and then what the treatments would be.

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