Areas of Care

Adult Epilepsy Program

Adult Epilepsy Program

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Electroencephalograms (EEGs)

An electroencephalogram (EEG) is a test to detect electrical activity in your brain. It uses small, metal cup-like discs attached to your scalp. Your brain cells communicate via electrical impulses and generate very weak electrical signals. These signals are active all the time, even when you are sleeping. This activity shows up as “wavy lines” and that record is called an EEG.

An EEG is one of the main diagnostic tests for epilepsy. An EEG can also play a role in diagnosing other brain disorders. The Ottawa Hospital has a full range of EEG studies available, including:

  • Routine EEG studies and sleep deprived EEG studies
    These studies tend to last up to 30 minutes and include video recording.
  • Ambulatory home-monitoring video EEG studies 
    These studies involve taking home equipment that allows your physician to record either 24 or 72 hours of your brain wave activity and include video recording. The recording allows us to record your brain activity and match it to your movements and behavior to try and help us identify where your seizures may be coming from. Recording for longer than a routine EEG study also means that we have more chances to capture if something unusual takes place.
  • Critical care video EEG studies
    These are inpatient studies performed on critically ill patients who are admitted to the hospital. They are usually not available to the public.

Routine EEGs are performed at either Civic or General campuses. Ambulatory and critical care EEGs are performed exclusively at the Civic Campus.

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Contact us

EEG laboratory

613 798 5555 ext. 14324

The Ottawa Hospital – Civic Campus
2nd Floor (Neuromuscular Centre)
1053 Carling Avenue, Ottawa, ON  K1Y 4E9

The Ottawa Hospital - General Campus 
Module Q, 2nd floor
501 Smyth Road, Ottawa ON  K1H 8L6 

Monday to Friday 8 a.m. to 4 p.m.

Other diagnostic tests

A neuropsychologist will guide you through a series of tests during your assessment. The testing session usually lasts about five hours. If necessary, testing can be completed across multiple appointments.

The assessment may include an interview, questionnaires, as well as testing your brain’s functions:

  • Attention and concentration
  • Memory
  • Visual and Spatial function
  • Language function
  • Reasoning and problem-solving
  • Social and emotional function

The purpose of an assessment is to identify your pattern of strengths and weaknesses. The results will help us make the best possible recommendations for your epilepsy care. This assessment will be one of the things your care team will consider when deciding whether or not epilepsy surgery is right for you because it helps your care team further isolate where in your brain your seizures may be coming from.

Neuropsychological testing must be done in person, but your interview and feedback session will be completed remotely (i.e. via phone or video conference). 

MRI stands for Magnetic Resonance Imaging. It is a technique used to create an image of the inside of the human body. An MRI of the head shows in great detail what your brain looks like and how it works. In people with epilepsy, an MRI scan may help to find the cause of the seizures, such as a scar, lesion, or altered anatomy in the brain. 

A CT scan is a computerized axial tomography scan and uses x-rays to take pictures of the brain. A CT scan may be the only option if you have a metal device that is surgically implanted in the body.

An MRI can typically produce a clearer and more detailed image than a CT scan.

These tests are usually performed at the General and Civic campuses of The Ottawa Hospital. Other places in the city may perform them, such as the Montfort hospital, the Queensway Carleton Hospital and Pembroke hospital, all of which have MRI capability. 

This test is usually ordered for patients diagnosed with epilepsy who may need epilepsy surgery. It is used to get more information on where their seizures are coming from.

A PET scan is a test that combines computed tomography (CT) and nuclear scanning. A tracer (radioactive substance + glucose) is injected into the vein, which travels to the brain and produces a signal on how the brain metabolizes the glucose (builds up and breaks down the glucose).

Areas in the brain that do not metabolize the glucose correctly light up differently and can help identify where the seizures are coming from in the brain.

This test is usually performed at the General Campus. 

Your neurologist may ask you to get a genetic test done if they see a pattern of inheritance in your family or syndrome with a strong genetic association playing a role in your epilepsy. They will consult with a neuro geneticist and refer you to them at the Children’s Hospital of Eastern Ontario (who also evaluates adults with genetic conditions).

More specialized tests may be required during your presurgical evaluation. You may need to travel to Toronto Western Hospital or the London Health Sciences Centre to complete the tests. These tests may include functional magnetic resonance imaging (fMRI), WADA testing or SPECT scans.

Tests needing intracranial electrodes to monitor your seizures will also take place in either Toronto or London. 

If your epilepsy specialist concludes that surgery might be right for you, they will likely refer you to one of our sister institutions and regional epilepsy surgical centers. The two major centers in the province are the Toronto Western Hospital and the London Health Sciences Centre.

Please discuss these options with your neurologist during your next appointment. 

Epilepsy resources

  • Epilepsy Ottawa is one of the four main pillars of the Ottawa Epilepsy Program and includes its community program. Its website has a number of useful resources, including videos, information pamphlets, and spark sheets on diagnosis, treatment of seizures and epilepsy. It also has a listing of local resources and programs.
  • Epilepsy Ontario and Drug Shortages Canada each has a list of current anti-seizure drug shortages. Please consult the links below to see how this could affect you
  • Epilepsy Ontario has many articles and patient info sheets written by epilepsy experts in Toronto, London and other parts of North America. Visit their dynamic YouTube channel for very useful videos on how seizures can manifest.
  • Global Genes has information on staying safe while living alone with epilepsy.
  • Useful information about this condition from the Canadian Epilepsy Alliance. 

Frequently asked questions

There are many options to treat epilepsy. Most patients respond to either the first or second prescribed medication to control seizures. By the third medication, the chances of controlling seizures is somewhat less likely (though still very doable!) As a result, we consider other options such as epilepsy surgery, neuro stimulation devices such as the vagus nerve stimulator or dietary therapies such as the ketogenic diet.

Please talk to your physician about your treatment options during your next appointment. You can also consult some of the resources on this webpage to get more information about these treatment options. You may call the clinic nursing line (613 798 5555 ext. 18102). 

In Ontario, physicians are legally required to report to the Ministry of Transportation patients over the age of 16 who have any impairment of awareness that may impact their ability to drive safely, such as a seizure. This kind of report is usually done after a patient has a seizure and goes to an emergency department.

Once the report is made, The Ministry of Transportation will send you a letter. This letter will likely state that your license has been suspended and that a medical update from a physician is required. The Ministry of Transportation usually requires that your seizures be controlled completely for three to 12 months before considering medical updates from physicians.

This is the process we follow to apply to have a driver’s license reinstated:

  1. The patient fills out their section of the Epilepsy and Seizure Form and sends it to our office.
  2. Once we receive this form from the patient, our office completes its section of the form within the next two weeks.
  3. Our office emails the completed form to the Ontario Ministry of Transportation.
  4. Upon receiving this request for license reinstatement, the Ontario Ministry of Transportation needs between two and six weeks to render a decision.
  5. After this period, the patient will receive a letter in the mail from the Ministry of Transportation indicating whether their license has been reinstated or if more information is required. Should more information be required, please contact our office.

Important note: We can not speed up this process or ask the Ministry of Transportation for extensions. The ministry makes all decisions related to suspending or reinstating your licence, not the physician.

You can find more information regarding driving and epilepsy on the Epilepsy Ontario website.  

If you feel your medications aren’t working, always ask yourself these questions:

  • Am I taking them regularly or am I forgetting to take them on occasion?
  • Do I take them at regular times? (for example 8 a.m. and 8 p.m.)
  • Have I experienced any recent triggers, such as
    • not enough sleep
    • occasionally drinking too much alcohol
    • recent illness (cold or flu)
    • not filling the same formulation of my medication at the pharmacy? (ask your pharmacist)

The nursing staff or neurologists will ask you the same questions. Your answers help us understand if your medications really aren’t working or if there are other factors triggering recurrent seizures.

If you feel you are very good at taking your medications as prescribed and cannot identify other triggers, you may need a change in what medications you take or how you take them.

If you feel this can’t wait until your next scheduled appointment, please call our clinic nursing staff and leave a message. They will return your call and discuss the next available options with your neurologist. Then they will talk to you about the next steps to take in treating your epilepsy.

Please contact the surgical centre directly. The administrative assistants can help you find the contact information. If you are unable to get through, please let the admins know and we will make every effort to find out where you are on the waiting list. Waiting times for assessments in surgical centres in the province presently range from four to seven months. 

There is good evidence behind use of cannabidiol (CBD) in patients with certain types of epilepsy. The data are driven by three randomized control trials (at the time of this write-up) that have shown efficacy of 35 to 50 percent for reducing generalized tonic-clonic seizures or drop attacks in both Lennox-Gastaut and Dravet syndrome populations (essentially patients with very severe epilepsies.)

Essentially cannabidiol appears to be no better or worse than any of the medications we currently use, and they should be used as a complementary agent and add-on therapy. Highly-purified cannabidiol in a very concentrated formulation is difficult to find, but not necessarily required (formulations containing THC may have a beneficial side effect profile for example).

Please talk to your doctor before changing or adding medications. 

For prescription renewals and updates, contact your pharmacy. Ask the pharmacist to fax a request for a medication refill or update to 613-761-5360 or 613-761-4752.

Please note: We need at least one week’s notice to respond to prescription renewal requests. 

Please call the epilepsy clinic. We will try to arrange a follow-up. Also call your family doctor and ask them to make a new referral. This will help avoid delays.