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About the Division

For patients diagnosed with epilepsy, our team offers a variety of treatment options, such as symptom management, medications, and surgery, based on seizure severity and patient preferences. This is based on a comprehensive approach including detailed history and review of previous evaluations and treatments, supplemented by additional testing as needed, including imaging (MRI, including specialized protocols for functional imaging, PET scans, ictal SPECT scans), EEG (routine EEG, ambulatory EEG, inpatient video EEG, and intracranial EEG), and special procedures (Wada, intraoperative and extraoperative brain mapping).

Neurologists lead this treatment process, closely guided by the entire group, including input from neurosurgeons and neuropsychologists. Decisions regarding epilepsy surgery and device implantations are always made at a multidisciplinary conference. Surgical options offered at Duke include open resection, stereotactic laser ablation of tissue, VNS (vagus nerve stimulatory), and RNS (responsive neural stimulator). We also offer a complete range of non-surgical treatments including medications, dietary therapies (ketogenic and Atkins diets), and psychological and psychiatric therapy. For interested patients, there are also options for participating in research trial of novel medications and techniques.

Program History

Duke University Medical Center has been at the forefront in the development and application of both medical and surgical treatments for epilepsy for the past 40 years. Duke was the first medical center in the Southeast to use intracerebral electrode implantation to determine the location of seizure onset.

Surgical treatment for uncontrolled epilepsy has been available at Duke since 1961. For a similar period, the National Institutes of Health have funded a basic science effort to investigate the pathophysiologic mechanisms and genetics of epilepsy.

Our expertise in the evaluation and treatment of epilepsy has evolved with advances in technology, such that epilepsy surgery is now available for many patients. This surgical approach of providing seizure relief with a low level of complications has been well-documented in scientific literature. Evolving and new techniques continue to increase the options available to patients for improving seizure control with lower risk and faster recovery than was possible in the past.