There had been three or four medicines for 50 years, then all of a sudden there were five new ones,” he said. “Many more things have changed since then in terms of therapy.”
He gained special expertise in epilepsy and uses it to help patients decide what is best for their specific needs. Options include surgery, an implant like a pacemaker, and medication.
First, a diagnosis
Not all seizures are epilepsy.
They can also be due to tumors or brain injury. Even stress can cause some form of attacks. Doctors diagnose epilepsy when an EEG shows abnormal electrical activity in the brain.
The East Campus offers onsite same- or next-day imaging to ensure a quick diagnosis.
If a patient suffers from epilepsy, Dr. Martinez puts his experience to work. “The best treatment depends on the patient, and they need to work with their doctor on that,” he said.
For some patients, medication remains the best option, and it is the first thing doctors try. Not every medication is right for every patient. To prescribe the right product and dosage, Dr. Martinez considers several factors:
- Type of seizures
- Likelihood of more seizures
- Age and gender
- Whether a patient has other medical conditions
Vagus Nerve Stimulation
VNS Therapy is sometimes called a “pacemaker for the brain.” A small device is implanted under the skin in the left chest. An electrode linked to the device is attached to the vagus nerve in the neck. It delivers an electric pulse at regular intervals, which helps in preventing seizures.
Patients who are aware they’re about to have a seizure can swipe a magnet over the device to deliver an extra pulse. If a person’s heart rate jumps suddenly, the device reads it as a sign of a seizure and can prevent it. That’s especially helpful if a patient has seizures while sleeping.
Dr. Martinez said the following patients are good candidates for VNS:
- Those who can’t have surgery because they are not adequate candidates
- Those who have lesions near a sensitive area of the brain
Up to 60 percent of patients see at least a 50 percent seizure reduction. It usually takes up to a year to see the full benefit.
Dr. Martinez has 15 patients using this technology. “It’s definitely been life-changing,” he said.
Patients with visible lesions that aren’t near a sensitive area like a speech or movement center of the brain are good candidates for surgery.
Brain surgery is a major undertaking, and Dr. Martinez is sensitive to that. “I help them understand the concept of intractability. If your epilepsy is intractable, the chance of pills making you seizure-free is 1-3 percent,” he said. “You can waste a lot of time trying medications.”
Surgery can help. “If you’re an appropriate candidate, the chance of surgery making you seizure free may be as high as 90 percent. You may still need medication, but now it’s going to work.”
For qualifying patients who are struggling with work, school, etc. due to seizures, he can explain how surgery can offer a better life in the long-term. Dr. Martinez refers patients to neurosurgeons for surgery. Afterward, he can monitor them locally.