Epilepsy & Seizures
Epilepsy & Seizure Care at UVM Health
Epilepsy (seizure disorder) is a neurological condition that occurs when brain cells generate bursts of electrical activity that cause repeated seizures. The seizures often happen without warning and can make you appear or act differently.
While there’s no cure for epilepsy, effective treatment can limit your seizures. Our epilepsy specialists help you understand your condition and offer the latest innovations in care.
Why Choose UVM Health?
At University of Vermont Health, we partner with you so you can thrive while living with epilepsy. As one of the region’s leading providers of epilepsy and seizure care, we offer:
- Whole-person care: Our compassionate professionals know that epilepsy is more than seizures. We work with you on related issues such as mood and sleep disorders, medication management, and difficulties with work and school.
- Advanced expertise: Our board-certified neurologists have subspecialty training in epilepsy and clinical neurophysiology and decades of experience caring for people with seizure disorders. They collaborate with a team of neuropsychologists, neurosurgeons, psychiatrists and specially trained nurses to provide comprehensive care.
- Academic focus: Our physician-leaders are active researchers, many of whom train the next generation of experts. You benefit from providers who research or have access to the latest options for treatment-resistant seizures.
Types of Seizures
A seizure’s location in the brain determines its type and symptoms. We care for people with all types of seizures, including:
Focal onset seizures start in one side of the brain. Types include:
- Focal onset aware seizure: You are awake and may experience strange emotions, tastes, smells, sensations or muscle jerks.
- Focal onset impaired awareness seizure: You seem confused and unaware of your surroundings. You may repeat movements like lip smacking, chewing or hand rubbing.
Generalized seizures affect both sides of the brain at the same time. Types include:
- Absence seizure: You look like you’re staring off into space.
- Atonic seizure: You lose muscle control and become limp.
- Tonic-clonic (grand mal) seizure: Your body stiffens, you lose consciousness, and your muscles convulse.
Nonepileptic seizures look like epileptic seizures. However, instead of the brain’s electrical activity causing the seizures, they are caused by issues such as:
- Mental health conditions, including anxiety, depression or post-traumatic stress disorder (PTSD)
- Physical conditions like low blood pressure or sleep disorders
Diagnosing Epilepsy
Epilepsy causes recurring seizures. However, having seizures does not always mean you have epilepsy. Your care team works closely with you to understand what’s causing seizures.
Your doctor will ask you and people close to you about your seizure symptoms, including what happens before, during and after them. Your doctor will also complete a thorough physical examination and ask about your medical history.
Certain tests can help diagnose your type of epilepsy and determine a treatment plan, including:
A neurological exam assesses how well your brain communicates with your body. Your doctor checks your muscle function, reflexes, speech and senses. They may watch you walk to detect coordination problems.
A series of tests can check your brain’s ability to process information. Your provider may ask you to remember words or do simple math problems. During a conversation your provider observes you closely to gauge factors such as your mood, attention level and reasoning ability.
Information from an EEG helps us understand the location and cause of your seizures. Your provider places small electrodes on your head that measure your brain’s electrical impulses. They may record you on video to correlate the brain activity visible on the EEG with your body’s actions.
You can have an EEG in the hospital or at home. If you have an at-home EEG, our registered technologists provide all the necessary equipment and instructions.
Advanced imaging allows us to take photos of your brain. We have the latest technology, including:
- 3T magnetic resonance imaging (MRI): Exceptionally powerful magnets and a computer work together to provide clear and detailed brain images.
- Computed tomography (CT) scan: X-rays and advanced computers create 3D pictures of cross-sections of your brain.
- Functional MRI (fMRI): Your doctor analyzes brain activity by watching how blood flows in your brain.
- Positron emission tomography (PET) scan: You receive a small, safe amount of radioactive substance (tracer) that collects in areas of high cell activity. The tracer allows us to see brain activity during a CT scan.
- Single-photon emission computerized tomography (SPECT) scan: Similar to a PET scan, you receive a tracer that allows us to see your brain’s blood flow during a CT scan.
Epilepsy Treatment
The goal of epilepsy treatment is freedom from seizures. As a health system anchored by an academic medical center, we offer an extensive array of treatment options, including:
Most epilepsy treatment plans start with medicine to limit and control seizures. You and your doctor will determine which seizure medication or combination of medications is right for you.
If medications alone don’t control your seizures, your doctor may discuss dietary therapy options with you. Some diets that are low in carbohydrates and high in fat can work with medications to limit epilepsy seizures.
Neuromodulation delivers tiny electrical currents to help the brain and nerves work correctly and avoid a seizure. Implanted device options include:
- Deep brain stimulation (DBS): Your neurosurgeon implants tiny electrodes in the areas of your brain where seizures start. A small device is implanted in your upper chest and connected to the electrodes by small wires. The device sends electric currents to the electrodes to prevent seizures. It can also report ongoing brain activity to your doctor.
- Responsive neurostimulation: Electrodes in seizure-prone areas of your brain are connected to a device implanted in your skull. When the device detects unusual activity, it sends electrical pulses to the electrodes to regulate brain waves before a seizure can start or spread.
- Vagus nerve stimulation: The vagus nerve in your neck sends electrical pulses to your brain. Your neurosurgeon connects an electrode to the vagus nerve. A small device implanted in your upper chest sends electric currents to the electrode. If you feel a seizure coming on, you can wave a magnet over the device to send extra pulses to the brain.
If you have a device implanted at a hospital outside of UVM Health, you can receive follow-up care within our health system.
If other therapies do not manage your seizures, your doctor may recommend epilepsy surgery. Your neurosurgeon removes brain tissue in the specific area where your seizures occur. Surgery is most effective when your seizures originate from one area of your brain (focal onset seizures).
If you have epilepsy surgery in a facility outside of UVM Health, you can receive follow-up care within our health system.
Patient Resources
- Epilepsy Foundation: An organization dedicated to epilepsy training, research and advocacy.
- Epilepsy Foundation of New England: Nonprofit organization whose mission is to help people and families affected by epilepsy in New England.
- Psychology Today - Find a Therapist: Find detailed listings for mental health professionals no matter where you live.
Locations Near You
111 Colchester Avenue
Main Campus, Main Pavilion, Level 2
Burlington, VT 05401-1473
111 Colchester Avenue
Main Campus, East Pavilion, Level 5
Burlington, VT 05401-1473
89 South Williams Street
Burlington, VT 05401-3405
111 Colchester Avenue
Main Campus, East Pavilion, Level 5
Burlington, VT 05401-1473
15 Degrandpre Way
Plattsburgh, NY 12901
111 Colchester Avenue
Main Campus, Patrick. Level 5
Burlington, VT 05401-1473
111 Colchester Avenue
Main Campus, East Pavilion, Level 4
Burlington, VT 05401-1473
130 Fisher Road
MOB-A Suite 1-6
Berlin, VT 05602-9000
