Video EEG Monitoring

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The Neurovascular Department at San Antonio Community Hospital (SACH) is committed to clinical excellence, superlative technical performance, and innovation in diagnosis and therapy. Among special services provided by our Neurovascular Department is the diagnosis and treatment of epilepsy—a common disorder.

Seizures that are unprovoked and recurrent are considered epileptic and are classified as either generalized seizures or partial seizures. Generalized seizures begin as widespread neuronal excitation in both hemispheres of the cortex, whereas partial seizures begin focally in a circumscribed area of the cortex.

Evaluation helps determine the type of seizures (epileptic versus nonepileptic) and their cause, since various seizure types respond best to specific treatments.

Diagnostic tests for epilepsy that are available at SACH include blood tests, EEG, and advanced imaging techniques such as MRI and MR Spectroscopy. Comprehensive, pre-surgical diagnostic procedures include prolonged video EEG monitoring, neuropsychological testing as a predictor of possible cognitive loss following surgery, the WADA (intracarotid sodium amobarbital procedure) test to help determine the risk of post-operative memory and language deficits, and intracranial EGG with simultaneous video monitoring.

Pharmacotherapy is a key component of epilepsy management. Factors to consider include seizure type and epilepsy type, side effects, ease of use of the Anti-Epileptic Drugs (AED) and cost. The goal is to achieve the best balance among efficacy, tolerability and safety. Because patients may take AEDs for many years, long-term efficacy and tolerability should be considered.

When medication is not effective in controlling seizures, surgical correction of epilepsy may be considered. Surgical options include resection of the epileptogenic focus. At SACH, we implant Vagus Nerve Stimulators, which is a device that produces electrical signals along the vagus nerve to help prevent seizures.

Testing to determine the source of the seizure and location in the brain is crucial in determining whether it is in fact epilepsy, and what the most effective treatment plan would be for the patient. San Antonio Community Hospital's Neurovascular Department can help.