You Have Drug Resistant Epilepsy – What’s Next?

Many patients with drug-resistant epilepsy have found seizure freedom or reduction through epilepsy surgery. If you haven’t already, you should seek out care from a specialized epilepsy center for further advanced treatment. If you and your epilepsy care team determine that epilepsy surgery is right for you, the journey leading to epilepsy surgery can be lengthy and have many different steps.  

The types of tests run will vary depending on your epilepsy care team, but may often include the following:

Video EEG

An electroencephalogram, also known as an EEG, is a test used to monitor the electrical activity in the brain. This test is performed by placing electrodes in various spots on the patient’s scalp. The electrodes are wired to a machine that allows the doctor to quickly see what areas of the brain are involved during seizures. Video EEGs are typically performed in a special hospital unit called the Epilepsy Monitoring Unit (EMU), where the EEG recording can be monitored while the patient is kept under video observation. When a seizure occurs, the EEG and video recordings can offer clues to the epilepsy care team as to what type of epilepsy you may have, and where the seizure focus may be. This information can help guide the doctor in your care.

MRI

Magnetic resonance imaging (MRI) is a common form of neuroimaging used to create a surgical plan for an epilepsy patient. An MRI provides the doctor with an extremely accurate image of what the patient’s brain looks like. This allows him/her to see the physical structure of the brain, and if there are any malformations that may be responsible for your seizures. 

Additional imaging

There are a variety of additional imaging types, including PET, SPECT, fMRI, and MEG. These all provide different images and information about the structure and function of your brain, which your doctor may use in order to plan your treatment.¹

Neuropsychological testing

You may meet with a neuropsychologist to do some tests that look into your brain’s ability to perform certain functions, such as memory, language, and attention.² The results from these tests can help provide your epilepsy care team with clues about where your epilepsy may be starting in your brain and how it can be treated.

WADA

Your epilepsy care team may request a WADA test, which consists of performing various language and memory tests while your doctor puts certain areas of your brain to sleep. This test can help lateralize your language area of the brain and assess memory function on each side of the brain.³

There are additional tests that your doctor might want to order. Every patient is different, and only your epilepsy care team can help you decide the best treatment plan for you.