Epilepsy and Seizure Disorders

World-Class Epilepsy Care

Dr. Passaro is recognized globally for his knowledge and expertise, with more than 20 years of experience diagnosing and treating epilepsy. He is the founding director of the Florida Center for Epilepsy/ Bayfront Health Epilepsy Program, one of only a handful of level IV epilepsy centers in Florida, the highest level certified by  of the National Association of Epilepsy Centers.

Epilepsy

Epilepsy is a disorder where someone has one or more unprovoked epileptic seizures. Epilepsy comes from the Greek, epilambanein, meaning to “seize.” Our brain is a network hub, made up of  greater than 100 billion  nerve cells that communicate by sending electrical and chemical signals to each other in an organized and regulated manner which allows us to see, feel, think, speak; it is what makes us uniquely human. However, when a group of these electrical and chemical nerve signals don’t communicate properly, seizures can occur.

Some people may have a single epileptic seizure, and never develop the condition of epilepsy itself. Research shows that if someone lives to around age 80, there is a one in 10 chance that they will experience a single epileptic seizure. More than 3.0 million people in the United States have active epilepsy, and 180,000 new cases of epilepsy are diagnosed every year. A large number of people with epilepsy can go several months to years prior to diagnosis.  During one's lifetime, there is a one in 26 chance of developing epilepsy.  Epilepsy is the fourth most common neurologic condition and costs the United State greater than 12.5 billion dollars annually in both direct and indirect costs. Epilepsy can start at any age, and is more common in children and adolescents and in people older than age 60.

The cause of Epilepsy can be discovered through a high resolution epilepsy protocol MRI. Epileptic seizures can be caused by several factors, including but not limited to:   severe head injuries, stroke, brain tumors, brain hemorrhage, an abnormal collection of blood vessels in the brain, birth trauma, brain infection, and malformed regions of the brain which occurred during brain development (20% of adult cases and 50 percent of childhood cases).  Some cases are genetic (12-15 percent).

However, it is important to note that even though some spells that look like epileptic seizures can represent a different condition including a sleep disorder, movement disorder, panic attacks, syncope, cardiac conditions, transient ischemic attacks and psychogenic non-epileptic seizures. Therefore, it is essential that a patient with new onset of unusual or funny spells be evaluated by a board certified epilepsy/seizure specialist. Delayed diagnosis can lead to not being treated or being given the incorrect treatment for the condition. Careful clinical history from the patient and family, review of MRI imaging and EEG data and in some cases video-EEG monitoring can establish the diagnosis. We have a highly specialized team of dedicated specialists including registered EEG technologists, certified physician assistants, social workers and neuropsychologists on our team.

During the initial visit, Dr. Passaro carefully analyzes the patient's aura and seizure symptoms to create an initial map of the patient's seizure network which he shows to the patient using an anatomic brain 3D model. He may ask you to focus on the details of your aura and ask family members to take videos of the seizures.  The goal is to accurately classify the type of epilepsy, where the seizures start and spreads to, determine the cause and to tailor the optimal therapy for a particular patient.

Seizures

The most easily recognized seizure type is a generalized tonic-clonic seizure (convulsion). However, seizures can take a variety of forms, such as a feeling of fear, a rising sensation in the
stomach, a brief stare, a lapse of memory, rapid jerks of one or more limbs, forced head turning to one side or a loss of muscle tone that lasts seconds to a few minutes. These forms of seizures can go unrecognized for months to years. Frequently, patients seek medical attention only after a convulsion, motor vehicle accident or unexplained lapses in memory. Epilepsy can be difficult to diagnose, especially when symptoms are subtle. Patients and their families may find it hard to accurately describe the seizures. Some patients who live alone may not even be aware of their seizures.

Advances in research and technology gives patients with epilepsy and seizures new hope for successful treatment. Bayfront Medical Center offers state-of-the art technology, and The Comprehensive Epilepsy Program at Bayfront Medical Center led by medical director Dr. Erasmo Passaro, who is nationally recognized for his work and experience in epilepsy. This program gives people suffering from this condition hope that they can live full and active lives.

Our practice offers services including:

  • First (new onset) seizure patient will be seen within one week
  • Focus on patient wellness with a multi-disciplinary epilepsy team
  • Advanced medical therapies
  • 3T volume MRI with a specialized epilepsy protocol and 32 channel head coil, to find the cause of your seizures
  • Functional MRI
  • Diffusion Tensor Imaging (DTI)
  • Ictal subtraction SPECT co-registered to MRI (SISCOM)
  • Digital long-term video-EEG monitoring and a dedicated in-hospital unit for around-the-clock evaluation.
  • Positron Emission Tomography (PET)
  • ROSA robot technology
  • Responsive neurostimulation (RNS)
  • Vagal Nerve Stimulation (VNS)
  • Functional brain mapping

Advanced Imaging to Localize Seizures

Magnetic Source Imaging

Brain positron Emission Tomography

Advanced MRI Brain Imaging at 3 Tesla with 32 channel Phase Array Coil

Diffusion Tensor Imaging of White Matter Tracts

The majority of people diagnosed with epilepsy (about 65 percent) will become seizure free with seizure medications. New developments in anti-epileptic medications give people more treatment options. Historically, about one-third of patients with epilepsy do not become seizure free with medication alone.

When two seizure medications fail to control epilepsy, the success rate of a new medication is roughly five to 10 percent. Continued seizures put patients a much greater risk for injury, a reduced quality of life, and sudden death. When medications cannot control epileptic seizures, Dr. Passaro can conduct a comprehensive evaluation to determine if epilepsy surgery is an option. Surgical options for epilepsy treatment are safe and highly-effective.

At Florida Center for Neurology, our mission is to strive for the best care and clinical excellence, and to raise awareness about epilepsy, advancing education and research. We take the time to talk with our patients, so that they understand their epilepsy diagnosis. We help to find optimal treatment for patients to recover and have a successful outcome, and have a good quality of life.

If you have any questions about epilepsy and seizures, please call our office at (727) 329-8833 to request an appointment with Dr. Passaro, or use our secure online appointment request form.

To learn more about the epilepsy program, please download our brochure