Volume 15, No. 1, 1999 Comments From the Editor

Epilepsy is the most prevalent serious neurological disorder able to affect individuals of any age. Between 0.5% and 1% of the population of the United States and world suffer from epilepsy, which is defined as a condition of spontaneously recurrent seizures. Many famous and infamous people are thought to have suffered from epilepsy: Julius Caesar, Alexander the Great, Napoleon, Peter the Great, King George, President James Madison, Fyodor Dostoyevsky, Jonathan Swift, Joan of Arc, Vincent van Gogh, Frederic Handel, and Alfred Nobel to name but a few.

Besides the obvious risk of physical injury associated with seizures, epilepsy can disrupt almost every aspect of a patient’s life. Complete control of seizures is therefore the primary goal of treatment to insure that the quality of patients’ lives does not deteriorate. Unfortunately, this goal can be difficult to attain.  Treatments, however, are improving and alternatives are increasing for patients afflicted with epilepsy as this issue of the BNI Quarterly, spearheaded by Dr. Robert Fisher, Chair, Division of Neurology, amply demonstrates.

Careful evaluation is needed to confirm a diagnosis of epilepsy, and seizures must be classified appropriately to insure that the optimal therapy is selected. If treatment is needed, antiepileptic drugs are the most common approach, but many drugs are available, including several recent additions to the market. Some patients may be candidates for surgical treatment, often an underutilized option for controlling intractable epilepsy. Furthermore, patients with nonepileptic seizures, a psychogenic disorder, can be difficult to diagnose. In such cases, tertiary centers staffed by a multidisciplinary team experienced with the special imaging techniques and procedures related to epilepsy may offer the most efficacious and cost-effective care.

Consequently, the BNI is fortunate to house an Epilepsy Center with a state-of-the-art inpatient monitoring unit and an outpatient Epilepsy Clinic. Under the direction of Dr. Fisher, this center provides technologically advanced diagnosis, treatment, and care for patients with epilepsy and related disorders through the combined efforts of neurologists, neurosurgeons, neuroradiologists, neuropsychologists, neurological nurses, and pharmacists. This talented group is on the forefront of developing new therapeutic options, offering new hope for patients with this ancient disorder.

Robert F. Spetzler, MD
Editor-in-Chief