Advanced Treatment Options for Drug‑Resistant Epilepsy
For many individuals with epilepsy, medications alone are not enough to achieve seizure control. When seizures continue despite appropriate medical therapy, advanced treatments such as neuromodulation or epilepsy surgery may offer meaningful improvement — and in some cases, the possibility of seizure freedom.
At Georgia Epilepsy & Neurology Institute, our physicians, Dr. Ki Hyeong Lee and Dr. Joo Hee Seo, provide expert evaluation and guidance for patients who may benefit from these advanced therapies. We offer comprehensive pre‑surgical assessments, neuromodulation evaluations, and seamless coordination with Emory Epilepsy Center and Children’s Healthcare of Atlanta (CHOA) for specialized procedures.
What Is Drug‑Resistant Epilepsy?
Epilepsy is considered drug‑resistant when seizures continue despite trials of two appropriate antiseizure medications at therapeutic doses. At this point, additional medications alone are unlikely to achieve full seizure control.
Advanced therapies — including neuromodulation and surgery — become important options.
Neuromodulation Therapies
Neuromodulation uses electrical stimulation to reduce seizure frequency and severity. These therapies are FDA‑approved, safe, and effective for many patients with refractory epilepsy.
Vagus Nerve Stimulation (VNS)
VNS delivers gentle electrical pulses to the vagus nerve to help regulate brain activity.
Who may benefit:
- Patients with focal or generalized epilepsy
- Children and adults with drug‑resistant seizures
- Individuals who are not candidates for brain surgery
Our role:
- Candidacy evaluation
- Pre‑implant counseling
- Post‑implant programming and long‑term monitoring
Responsive Neurostimulation (RNS)
RNS is a “smart” device implanted in the skull that detects abnormal electrical activity and delivers targeted stimulation to prevent seizures.
Who may benefit:
- Adults with focal epilepsy
- Patients with 1–2 seizure foci
- Individuals who have not responded to medications
Our role:
- Pre‑surgical evaluation
- Coordination with Emory or CHOA for implantation
- Long‑term device monitoring and data review
Deep Brain Stimulation (DBS)
DBS delivers continuous stimulation to deep brain structures involved in seizure activity.
Who may benefit:
- Adults with drug‑resistant focal epilepsy
- Patients who are not candidates for resective surgery
- Individuals with multifocal seizure onset
Our role:
- Candidacy assessment
- Surgical pathway coordination
- Post‑implant follow‑up
Epilepsy Surgery Pathways
For some patients, surgery offers the best chance for seizure freedom. Modern epilepsy surgery is highly advanced, safe, and tailored to each patient’s unique seizure network.
We guide patients through every step of the surgical evaluation process.
Pre‑Surgical Evaluation
A comprehensive evaluation determines whether surgery is a safe and effective option. This may include:
- High‑resolution MRI
- Video EEG monitoring
- Neuropsychological testing
- Functional imaging (PET, SPECT, MEG)
- Genetic and metabolic evaluation
- Seizure network mapping
We coordinate these studies and interpret results to build a complete clinical picture.
Surgical Options
1. Resective Surgery
Removal of the seizure‑generating area of the brain.
2. Laser Interstitial Thermal Therapy (LITT)
A minimally invasive laser procedure guided by MRI.
3. Corpus Callosotomy
Used primarily in children with drop attacks or generalized seizures.
4. Hemispherectomy / Hemispherotomy
Reserved for severe, unilateral pediatric epilepsies.
We collaborate with Emory and CHOA to ensure patients have access to the full range of surgical options.
Our Collaborative Approach
We maintain close partnerships with:
- Emory Epilepsy Center
- Children’s Healthcare of Atlanta (CHOA)
- Specialized neurosurgeons
- Neuropsychologists
- Advanced imaging centers
This ensures that every patient receives the right level of care — from community‑based management to tertiary‑level surgical intervention.
Who Should Be Evaluated for Neuromodulation or Surgery?
You may be a candidate if:
- You have tried two or more antiseizure medications without adequate control
- You experience frequent or disabling seizures
- Your seizures interfere with school, work, or daily life
- You have a known seizure focus on EEG or imaging
- You have a genetic or structural epilepsy that may respond to targeted therapy
Early evaluation improves long‑term outcomes.
Our Philosophy: Hope Through Advanced Care
Advanced epilepsy therapies are not a last resort — they are powerful tools that can transform lives. Our goal is to provide:
- Clear explanations
- Evidence‑based recommendations
- Seamless coordination
- Lifespan follow‑up
- Compassionate support for patients and families
We walk with you through every step of the journey.