Treatments & Procedures

Advanced Treatments for Epilepsy

Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures due to abnormal, excessive, or synchronous electrical activity in the brain. Contrary to common misconceptions, epilepsy is not caused by "damaged brain cells" in all cases - seizures can arise from genetic, structural, metabolic, immune, or unknown causes, even in structurally normal brains.

Seizures may manifest as alterations in awareness, behavior, movement, sensation, or emotions, depending on the brain region involved.

While epilepsy is not curable in some cases, it is highly treatable, and curable with surgery in others. With appropriate therapy, approximately 70% of patients achieve long-term seizure freedom. The Epilepsy Program at Cleveland Clinic Abu Dhabi delivers comprehensive, multidisciplinary care, integrating advanced diagnostics (including high-resolution MRI, video-EEG monitoring, and genetic testing), precision medical therapy, epilepsy surgery, neuromodulation (VNS, RNS, DBS), and dietary therapies, all tailored to each patient’s unique epilepsy syndrome.

Advanced Technology in Epilepsy Management

The program uses advanced diagnostic tools to accurately diagnose and classify epilepsy, including:

Electroencephalography (EEG): This measures the brain’s electrical activity, looking for abnormal electrical patterns that may be related to seizures.
Epilepsy Monitoring Unit (EMU): State-of-the-art technology is used to evaluate patients for epilepsy, characterize the patient’s types of seizures and their location, determine the frequency, type and nature of a patient's seizure episodes and identify between epileptic and non-epileptic disorders. By monitoring the brain and heart activity via continuous EEG and recording body movement of patients continuously (day and night) on video, doctors can ensure they are classifying the epilepsy accurately and providing the best treatment plan.
Functional MRI: This test uses magnets and tracks blood flow during particular tasks to try to localize important regions in the brain for language, memory, and motor tasks during surgical planning.
Voxel Based Morphometry (VBM): A neuroimaging technique that looks at focal differences in the brain’s cortical thickness and grey-white matter junction, helping to identify subtle structural abnormalities that are undetectable on routine MRI by the naked eye and may be associated with the underlying epilepsy.
Positron Emission Tomography (PET) scans: This test uses a radiotracer to localize the area of the brain that is not taking up glucose (sugar) like the rest of the brain and gives doctors a clue as to the region that is affected by the seizures.
Ictal Single Photon Emission Computed Tomography imaging (SPECT) scans: This test is performed in the Epilepsy Monitoring Unit under the supervision of a team of experts (nuclear medicine technician, neurophysiology technician and a nurse) during which a radiotracer is injected early in the seizure to localize the blood flow to the brain during a seizure, and is also helpful in giving doctors an idea of the region of the brain where the seizure begins and spreads.
Robotic stereoelectroencephalography (SEEG): For patients requiring invasive evaluation, this minimally invasive procedure allows precise localization of the seizure onset zone , enabling safer and more effective surgical planning.
Functional MRI with diffusion tensor imaging (DTI): Combining functional MRI with DTI, the test measures water molecule diffusion and its directionality. It allows doctors to visualize both brain activity necessary for a certain critical task and white matter connectivity, offering insights into how epilepsy affects brain networks and functions, and avoiding deficits after surgery.
Electrical Source Imaging (ESI): This is an advanced neuroimaging method that localizes the source of abnormal electrical activity in the brain, helping to identify the seizure focus and plan surgical interventions for epilepsy patients.

Treatment options for people diagnosed with epilepsy at the Cleveland Clinic Abu Dhabi include:

Dietary recommendations and treatment.
Medication management: Anti-seizure medications can control seizures in approximately two thirds of the patients. There are many types available, and your doctor will work with you to find the one that works best for you, depending on factors such as seizure type, response to previous medications, side effect profile, your age, overall health and more.
Surgical interventions: If medication isn’t working, and seizures are severe, surgery may be recommended. Interventions include removal of the abnormal tissue causing the seizures (resection), disconnection of nerve fibers in the brain, destroying areas of abnormal tissue via electrical or laser ablation and implantation of a device which sends electrical signals to the brain to reduce seizures (neuromodulation devices).
Neurostimulation: This applies to patients who are not candidates for resective surgery but are experiencing a significant seizure burden or medication side effects, and involves surgery to implant a device that delivers electrical impulses to the brain via the vagus nerve (in the neck) or directly to the thalamus (inside the brain) to reduce the frequency of seizures.
RadioFrequency Ablation (RFA): A minimally invasive procedure that uses heat generated by radiofrequency energy delivered through a small probe (often via electrodes that were already implanted for monitoring, called sEEG-guided RFA) to destroy abnormal tissue.

Laser Interstitial Thermal Therapy (LITT): A minimally invasive neurosurgical procedure that uses a laser probe, guided by MRI, to heat and destroy (ablate) the small, specific area of the brain where seizures originate. It is often used as an alternative to traditional, more invasive open brain surgery for certain types of drug-resistant epilepsy.

In addition to advanced treatment options, the Epilepsy Program at Cleveland Clinic Abu Dhabi offers comprehensive support services. This includes educational resources, counseling, and support groups to enhance the overall well-being of patients and their families.

This information is provided by Cleveland Clinic Abu Dhabi, part of the M42 group, and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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