Epilepsy

Correct diagnosis and sustainable treatment of epilepsy and seizure-related disorders

Epilepsy is a complex disorder with many various causes, and it is one of the most common neurological diseases. The main symptoms are epileptic seizures, whose phenomena can be very different and which – depending on their severity – can have decisive influence on the everyday lives of patients. Severe epileptic seizures can, in worst-case scenarios, be fatal or heavily burden people with health and social difficulty. Even minor seizures can significantly restrict patients at school, at work and in their private lives.

Epilepsy is not a single disease. Rather, it comprises a large number of central nervous disorders and diseases, all of which have epileptic seizures as leading symptoms. Genetic disposition also plays a significant role. Whether people with epilepsy have their first seizures earlier or later in their lives depends on their predisposition. Once genetic causes have been clarified, forms of therapy can be devised in more targeted manners, and patients wishing to have children can be better advised. In addition to epileptic seizures, seizure-related disorders in which epilepsy is not the cause also exist. These include certain disorders of the motor system, syncope and mental illness. Differentiation is often associated with great diagnostic difficulty.

Epilepsy is a complex disorder with many various causes, and it is one of the most common neurological diseases. The main symptoms are epileptic seizures, whose phenomena can be very different and which – depending on their severity – can have decisive influence on the everyday lives of patients. Severe epileptic seizures can, in worst-case scenarios, be fatal or heavily burden people with health and social difficulty. Even minor seizures can significantly restrict patients at school, at work and in their private lives.

Epilepsy is not a single disease. Rather, it comprises a large number of central nervous disorders and diseases, all of which have epileptic seizures as leading symptoms. Genetic disposition also plays a significant role. Whether people with epilepsy have their first seizures earlier or later in their lives depends on their predisposition. Once genetic causes have been clarified, forms of therapy can be devised in more targeted manners, and patients wishing to have children can be better advised. In addition to epileptic seizures, seizure-related disorders in which epilepsy is not the cause also exist. These include certain disorders of the motor system, syncope and mental illness. Differentiation is often associated with great diagnostic difficulty.

In Germany alone, more than 600,000 people live with epilepsy – and every year, approximately 40,000 new people, from all age groups, are affected by it. About 200,000 of them are considered difficult to treat. As anti-epileptic drugs do not render these patients seizure-free, special diagnostics and therapies are required.

The Beta International Epilepsy Centre (Beta IEC) investigates the causes of this chronic central nervous system disease, examines differential diagnoses and develops individual forms of therapy for patients of all ages.

Prof. Dr. med. Christian E. Elger is the head of the Beta IEC. The seasoned epilepsy specialist is internationally esteemed and has many years of experience in the research and treatment of epilepsy. He was the director of a renowned hospital and research institution for many years. In 2018, together with Prof. Dr. med. Thomas Gasser and Dr. med. Axel Jung, he founded the Beta IEC and took over its medical leadership – after more than 25 years as the Director of the Clinic and Polyclinic for Epileptology at the University of Bonn. Via interdisciplinary exchanges with the neurology, clinical neurophysiology and neurosurgery departments, the Beta IEC enhances the Bonner Bogen medical facility.

For the diagnosis of epilepsy, Beta IEC specialists use the Beta Klinik’s modern equipment, such as magnetic resonance imaging (3 Tesla MRI scanner), to examine the brain. Resultingly, changes in the cerebral cortex can be recognized as possible causes of epilepsy.

In addition, certain parameters have to be clarified, such as

• descriptions of seizures
• differential diagnosis of seizure disorders
• epilepsy history
• medication history
• level of anti-epileptic drugs
• neuropsychological diagnostics
• causes of epilepsy, including genetics and autoimmune diseases
• short and long-term electroencephalography, including video recording (also via implanted electrodes)

 Therapeutic range of services

• drug treatment
• ketogenic diet
• epilepsy surgery with MR laser ablation
• resective epilepsy surgery (in cooperation with the University of Bonn Neurosurgical Clinic)
• stimulation therapy for epilepsy (vagus nerve stimulation)
• treatment of autoimmune diseases and associated epilepsy
• treatment of patients with tuberous sclerosis and associated epilepsy
• treatment of patients with other neurological disorders, such as migraine

In close cooperation with the neurosurgery team, all diagnostic procedures involved in the preparation of epilepsy surgery – the implantation of stereotactic electrodes for the localization of epileptic foci – can be implemented. MRI-guided laser ablation makes these epilepsy surgery procedures particularly gentle.

As a result of close cooperation with the BetaGenese Klinik, which is also located on the Beta Klinik campus, patients, particularly those with psychogenic, non-epileptic seizures, who would rarely receive joint care elsewhere (psychosomatic medicine and epileptology), can receive excellent treatment.

Interdisciplinary communication and a lively, close exchange of medical knowledge among the various medical disciplines at the Beta Klinik make personalized examination and treatment of epilepsy, with its various facets, possible.