In this article, you’ll learn:
- What epilepsy is and how it affects the brain.
- How it’s diagnosed and treated, from medications to advanced therapies.
- Options for hard-to-control seizures, including VNS and RNS management.
- What compassionate care with Dr. Neil Patel looks like.
- Why hope and quality of life are central to every treatment plan.
What is epilepsy?
“Epilepsy is a neurological condition that’s marked by abnormal electrical activity of the brain,” says Dr. Neil Patel, a board-certified neurologist who specializes in epilepsy care at Roper St. Francis Healthcare. The cause of epilepsy can vary widely from person to person. In some cases, genetics plays a role, while in others, epilepsy may develop as a result of an injury, infection, age or even certain autoimmune disorders. The effects of epilepsy on the brain are also unique for everyone affected by it. “It can occur across the whole brain all at once or start in a small part of the brain and stay there – or even spread.”
Dr. Neil Patel, Roper St. Francis Physician Partners Neurology. Learn more about Dr. Patel.
Seizures can look very different from person to person. Some are subtle, brief lapses in awareness that others might not notice. Others involve loss of consciousness or uncontrolled movements. Epilepsy can begin at any age, which is why a careful history and the right testing (often an EEG) matter.
How is epilepsy treated?
In most cases, epilepsy can’t be cured, but it can be treated and managed. Diet, sleep and stress relieving techniques like meditation can help manage epilepsy from day to day, but many people also benefit from medication. “Treatment is primarily oral medications,” Dr. Patel explains. “For about 70 percent of patients, we can get them seizure-free with a single anti-seizure medicine.” When one medicine isn’t enough, doctors may adjust doses or combine therapies.
For patients whose seizures don’t respond to first-line medicines, Dr. Patel provides a thorough diagnostic evaluation and individualized care plans. Options may include:
- Comprehensive evaluation for neuromodulation therapy. Dr. Patel offers diagnostic evaluations for refractory epilepsy and, when appropriate, will coordinate referral for implantation of a vagus nerve stimulator (VNS) or responsive neurostimulation (RNS) device at partnering centers.
- Ongoing device management. “If you’ve had a VNS or RNS placed elsewhere, I can manage and fine-tune your device settings as part of your long-term care,” Dr. Patel says.
- Rescue (abortive) medications. “Modern care also includes medicines patients or caregivers can use to shorten a seizure and help keep people out of the ER,” he notes.
Dr. Patel’s expertise includes managing refractory epilepsy, extended EEG monitoring, and device therapies like vagus nerve stimulation (VNS) and responsive systems. He has served in leadership at a Level 4 epilepsy center, which is the highest designation, and stays current by participating in clinical trials.
What to expect from care with Dr. Patel
Dr. Patel’s expertise includes managing refractory epilepsy, extended EEG monitoring, and device therapies like vagus nerve stimulation (VNS) and responsive nerve stimulatory systems. He has served in leadership at a Level 4 epilepsy center, which is the highest designation, and stays current by participating in clinical trials.
“When I meet a patient for the first time, they should expect someone who attentively listens to their concerns and then strives to find a pathway forward – through medicines, diagnostic testing and more,” Dr. Patel says. “I take a lot of pride in being there for my patients throughout every step of their medical care.”
His clinic style is warm and plain-spoken. “My communication style tends to be very casual. I like to break complex topics into everyday language so people walk out knowing the plan and why it makes sense.” He strives to remove barriers, return calls quickly, and support families between visits.
Life beyond seizures
One of Dr. Patel’s deepest motivations is seeing life stabilize again for patients and families. “It’s incredibly meaningful when someone with epilepsy can go to bed without worrying they’ll have a seizure at school, at work or in an embarrassing situation,” he says. “I’ve cared for Division I college athletes, physicians and parents who live full, satisfying lives with epilepsy.”
And for caregivers? “Arming a mom with a plan – so she can finally sleep – may be the most satisfying part of this job,” he adds.
When should you see a neurologist?
If you’ve had a first seizure, episodes of staring or lost time, abnormal movements you can’t explain, or blackouts with confusion afterward, it’s time to be evaluated. Even if you’ve lived with seizures for years, new therapies may improve control and quality of life.
“My goal is simple,” Dr. Patel says. “Listen closely, find the diagnosis, and work tirelessly to get you the best control possible so you can get back to your life.”
Dr. Neil Patel is a board-certified neurologist with fellowship training in epilepsy. He cares for the full spectrum of neurological conditions – including migraine, stroke, neuropathy, multiple sclerosis, myasthenia gravis, dementia and specializes in advanced epilepsy management.
Ready to talk? Call (843) 723-8823 to schedule an appointment.