April 24, 2026
Mayo Clinic neurologists take time to thoroughly assess people with epilepsy, to determine an approach that might ease seizure burden and improve quality of life. As a quaternary center, Mayo Clinic has experience treating patients with challenging seizure disorders.
"Patients are looking for answers. They can get frustrated and feel as though they're just churning through medications and still struggling. We look at their stories with fresh eyes and see where we need to go, based on what they've experienced," says Amy Z. Crepeau, M.D., a neurologist at Mayo Clinic in Phoenix/Scottsdale, Arizona.
Mayo Clinic's multidisciplinary approach means that neurologists, neurosurgeons, neuroradiologists, neuropsychologists and geneticists bring their expertise to this care. State-of-the-art imaging technology, including 7T MRI and magnetoencephalography (MEG), further helps with diagnosis and treatment. Mayo Clinic researchers also are working to find innovative approaches to epilepsy treatment.
"Figuring out what makes sense for each individual takes time and high-quality testing, and it takes a team of specialists who can craft a comprehensive plan," Dr. Crepeau says. "At Mayo Clinic, we're structured to do that." Expert management of epilepsy is available across the enterprise.
State-of-the-art imaging
Mayo Clinic's evaluation of patients with epilepsy starts with assessing medications. "We want to work with patients to find medications that better control their seizures and avoid debilitating side effects," Dr. Crepeau says.
About one-third of people with epilepsy don't respond to medication. Surgery or targeted ablation are potential options if seizure origin sites can be localized. "Our technology increases the likelihood that we can find that cause," Dr. Crepeau says.
Sharper definition
Images from 3T MRI and 7T MRI performed in the same patient with focal cortical dysplasia. Subtle blurring of the gray-white matter junction with white matter signal abnormality (white arrows) is better defined at 7T due to the higher spatial resolution and decreased image noise.
High-resolution 7T MRI is available at Mayo Clinic's campuses in Jacksonville, Florida, and Rochester, Minnesota, as well as in Arizona. That technology better identifies epileptogenic lesions compared with conventional 3T scans.
"The underlying malformations are often very subtle foci of blurring at the cerebral cortex-white matter junction. The lower noise, increased spatial resolution and increased contrast resolution at 7T are particularly helpful for this indication," says Justin Cramer, M.D., a neuroradiologist at Mayo Clinic's campus in Arizona.
Precise imaging also can greatly improve surgical outcomes. "7T MRI is a critical tool for determining if a patient is a good candidate for curative treatment," Dr. Crepeau says.
Sophisticated imaging also plays a key role in Mayo Clinic's epilepsy research. One focus of that work is gene and stem cell therapies, which target scarred or dysfunctional brain tissue.
"We sometimes need higher resolution imaging to determine if patients have those structures of damaged tissue that can make them good candidates for these emerging therapies," Dr. Crepeau says.
"Our technology increases the likelihood that we can find that cause."
Mayo Clinic's campuses in Arizona, Florida and Minnesota also offer subtraction ictal single-photon emission computerized tomography (SPECT) coregistered to MRI (SISCOM). Developed by Mayo Clinic, SISCOM analyzes differences in blood flow as shown by SPECT scans performed during a patient's seizure and then while the patient isn't having a seizure. Superimposing those images on a patient's MRI allows a neurologist and neurosurgeon to identify where seizures originate.
MEG is a newer tool that helps target locations for stereoelectroencephalography (sEEG) electrode placement, to verify possible sites of seizure onset before epilepsy surgery. Mayo Clinic's campus in Minnesota is one of the few centers in the United States that routinely offers MEG.
The system records, analyzes and localizes minute magnetic fields produced by the brain's electrical currents. With the help of mathematical modeling, abnormal magnetic fields are then superimposed onto an MRI scan of the patient's brain to pinpoint the source of abnormal activity.
Seamless collaboration
Mayo Clinic offers the full range of surgical and nonsurgical epilepsy treatments. Specialists across departments and campuses routinely work together.
"Our relationships across campuses allow us to provide patients access to advanced techniques," Dr. Crepeau says. "For example, if I send a patient to Rochester for MEG studies, I can access the results and communicate directly with the neurologists who are interpreting them."
Treatment options for epilepsy continue to improve. "There always are new drug developments. Neuromodulation is growing by leaps and bounds," Dr. Crepeau says.
She notes that stimulation parameters are being developed to treat seizures that involve large areas of the brain. "We are getting a lot better information regarding the types of small targets within the brain that we can stimulate to affect that whole seizure network," Dr. Crepeau says. "It's going to be an exciting field over the next 10 to 15 years."
For more information
Refer a patient to Mayo Clinic.