Focal seizure treatment

Focal seizure treatment

If you’ve been diagnosed with focal seizures, you’ll be prescribed an anti-seizure medication. Your doctor will start with a low dosage and adjust this as needed. The choice of anti-seizure medication will depend on a number of factors, including the types of seizures you experience, your health history, age, whether you are a woman contemplating preganancy, among other things. Sometimes it is necessary to combine two or more antiseizure medications. 

Additional treatment may include lifestyle changes. If these treatment options are not effective in controlling seizures, non-medication treatments may be considered, such as epilepsy surgery or neurostimulation. Some patients may also be interested in or qualify for investigational medication trials.

The Comprehensive Epilepsy Center of the Neuroscience Institute offers a variety of medical and surgical treatment options to control and prevent focal seizures. Our multidisciplinary team offers leading edge treatments including minimally invasive surgery using stereoelectroencephalography (SEEG) and laser ablation, as well as the full range of surgical treatments. These minimally invasive techniques offer individuals reduced hospital stay and discomfort following surgery, while still providing an effective treatment for controlling seizures when medications have not succeeded.  In some cases other types of epilepsy surgery or neurostimulation surgery may offer more benefit, and our team will guide individuals in the choices available.  Our expert team at the Epilepsy Center performs between 50 and 100 epilepsy surgeries each year, and 90 percent of individuals receiving surgery are either seizure-free or have reduced seizures one year after surgery. The types of epilepsy surgery offered are:

  • Focal resection – removing a portion of the brain where seizures originate with either minimally invasive techniques or with standard surgical methods.
  • Responsive neurostimulation (“Neuropace”) – Implaning a small pacemaker-like device  to counter-act the development of seizures by stimulating brain regions were seizures begin.
  • Vagus nerve stimulation (VNS) – Implanting a small pacemaker-like device into the chest to stimulate the vagus nerve to reduce the likelihood of seizures
  • Disconnection surgery – cutting the nerve fibers to interrupt the spread of seizures from hemisphere to hemisphere within the brain
  • Hemispherectomy – removing almost an entire side of the brain to eliminate the area responsible for causing seizures

Our approach

The Comprehensive Epilepsy Center of the Northwell Health Neuroscience Institute offers a variety of medical and surgical treatment options to control and prevent focal seizures. Our multidisciplinary team offers leading edge treatments including disconnection surgery, stereoelectroencephalography (SEEG), laser ablation, combined stereoelectroencephalography (SEEG) and laser ablation, vagus nerve stimulation (VNS) and Gamma Knife. The expert team at the Epilepsy Center performs between 50 and 100 epilepsy surgeries each year, and 90 percent of patients are either seizure-free or have reduced seizures one year after surgery. 

Focal seizure treatment risks

Medication to control focal seizures is often highly effective. However, there are often side effects which include:

  • Nausea
  • Decreased appetite
  • Dizziness
  • Insomnia

Surgery should only be considered if anti-seizure medications have not been effective at controlling seizures. As with any surgery, there are general risks with procedures to control focal seizures. These include:

  • Blood clots
  • Blood loss
  • Heart attack
  • Stroke
  • Reaction to medication

Additionally, there are side effects that may occur after the surgical procedures, including:

  • Scalp numbness
  • Fatigue
  • Depression
  • Headaches
  • Difficulty speaking
  • Loss of memory

Focal seizure post-treatment

Following surgery, you will typically stay in the hospital for several days. Most patients are able to return to normal activities within six to eight weeks. Although the surgery should help minimize your seizures, you will continue to take anti-seizure medication as prescribed by your doctor.