Dr. Ahmed: 'Epilepsy very complex, chronic disease of the brain'

Amy Charles

One in 26 Americans will develop epilepsy in their lifetime. The Centers for Disease Control and Prevention (CDC) reports that 1.2 percent of the United States population, or about 3.4 million people, have active epilepsy.


It is not clear what causes epilepsy.


Epilepsy can be caused by different conditions that affect a person's brain. Many times the cause is unknown. Some causes include stroke, brain tumor, traumatic brain injury or head injury and central nervous system infections.


"Epilepsy is a very complex and chronic disease of the brain that is characterized by altered awareness and loss of consciousness, or seizures," explains Dr. Naveed Ahmed, Pikeville Medical Center (PMC) neurologist. "The frequency of these seizures can be disabling." It is diagnosed by history of episodes and by electroencephalogram (EEG).


At PMC epilepsy can be treated in various ways.


"Proper diagnosis is the first step in treatment, then education," explained Dr. Ahmed. "Medication is the next step in treatment and an assessment to determine if the patient is a candidate for surgical treatment, or vagus nerve stimulation."


Epilepsy can affect people in very different ways. The frequency of seizures plays a major role in determining both the severity of the person's condition and the impact it has on his or her life.


Most people with epilepsy live a full and healthy life. However, epilepsy can be fatal. The leading cause of epilepsy-related death is believed to be sudden, unexpected death in epilepsy, also known as SUDEP.


Dr. Ahmed is very concerned about SUDEP as the most serious complication of epilepsy that is left untreated. It occurs in someone who is otherwise healthy. In SUDEP cases, no other cause of death is found when an autopsy is done. Each year, about one in 1,000 adults and one in 4,500 children with epilepsy die from SUDEP. This is the leading cause of death in people with uncontrolled seizures.


According to Mayo Clinic, many people with epilepsy can become seizure-free by taking anti-seizure medication. Medications do not work for everyone suffering with epilepsy. About one in three cases are resistant to medication.


Those who are resistant to medications often have the doses increased in attempts to better manage the seizures. Side effects of prolonged usage of high doses of seizure medication are gum disease, weakened bone density and excess facial hair in women.


When the usual medications fail to control epileptic seizures, implantation of the vagus nerve stimulator can help.


Vagus nerve stimulation (VNS) is a cutting-edge procedure performed at PMC by Dr. Greg Hazelett and Dr. William Hoskins, PMC otolaryngologists. It is designed to prevent seizures by sending regular, mild pulses of electrical energy to the brain via the vagus nerve. These pulses are supplied by a device something like a pacemaker.


VNS is not a curative treatment, but has shown significantly reduced seizures by sensing and stopping them before they happen. Statistics show 60 percent or better improvement rate in most patients.


If you suspect someone is having a seizure, Dr. Ahmed insists on calling 911 immediately and putting them on their side. If at all possible, video the occurrence to show a physician later to help explain what happened during the episode.


For more information or to make an appointment, please call 606-218-2208.