Adult and pediatric epilepsy evaluation and ongoing seizure care, led by board-certified neurologist Dr. Thomas Kurian, MD — close to home in Santa Clarita.
overview
Epilepsy care is not just about prescribing a medication. It is about the right diagnosis, the right medication match, and partnership over months and years to keep you safe, working, and driving when possible.
The first visit is a thorough conversation. We talk through what you (or a witness) noticed before, during, and after the event. We ask about prior seizures, family history of seizures or epilepsy, head injuries, sleep, alcohol or recreational drug use, and current medications. The story of the event is often more important than any test, so it helps if a family member or witness can join — even by phone.
The neurological examination is brief and non-invasive. From there, the typical workup includes blood tests, an EEG to look at the brain's electrical patterns, and (in most cases) an MRI of the brain to look for structural causes. Some patients also need ambulatory or prolonged EEG monitoring to capture events that don't show up on a routine study.
The right anti-seizure medication depends on the seizure type, the EEG and MRI findings, your other medical conditions, your other medications, your reproductive plans, and your tolerance for side effects. The goal is the same for every patient: no seizures, no significant side effects.
defining the condition
Plain-language definitions of the seizure terms you will hear in our office.
A single event of abnormal, excessive electrical activity in the brain. A seizure may produce a wide range of experiences — from a brief staring spell to a full convulsion — depending on which part of the brain is involved.
A disorder of recurrent unprovoked seizures. The diagnosis is usually made after two or more unprovoked seizures separated by at least 24 hours, or after a single seizure with a high estimated risk of recurrence.
A seizure that begins in one area of the brain. Focal seizures may occur with preserved or impaired awareness and may include strange sensations, déjà vu, automatic movements, or local jerking. Some focal seizures spread to become bilateral tonic-clonic seizures.
A seizure that involves both sides of the brain from the start. Subtypes include tonic-clonic (convulsive), absence (brief staring), myoclonic (sudden jerks), and atonic (sudden loss of muscle tone) seizures.
A focal seizure with preserved awareness — often the first part of a longer seizure. Common auras include a rising feeling in the stomach, déjà vu, an unusual smell, or a brief visual change. Recognizing your aura can help with safety planning.
A seizure lasting more than 5 minutes, or two or more seizures back-to-back without recovery in between. This is a medical emergency and requires immediate emergency care.
treatment options
There are now more than two dozen FDA-approved anti-seizure medications, and the right one depends on the seizure type and the patient.
Levetiracetam, lamotrigine, valproate, topiramate, zonisamide. These work for both focal and generalized seizures and are common first choices in most adults and many pediatric patients.
Lacosamide, oxcarbazepine, carbamazepine, eslicarbazepine, brivaracetam. These are particularly useful for focal-onset seizures and may have specific advantages depending on the patient's profile.
Some medications are preferred in children due to better tolerability, simpler dosing, or better cognitive profiles. Childhood epilepsy syndromes — absence epilepsy, juvenile myoclonic epilepsy, benign rolandic epilepsy — often have specific first-line choices.
For women of childbearing age, medication choice considers fetal safety. Lamotrigine and levetiracetam are generally preferred. We coordinate with the patient's obstetrician on folic acid supplementation, monitoring, and dose adjustments through pregnancy.
If two appropriately chosen and dosed medications fail to control seizures, the epilepsy is considered drug-resistant. At that point, we discuss referral to a comprehensive epilepsy center for evaluation for surgery, neurostimulation (VNS, RNS, DBS), or dietary therapy.
Consistent sleep, avoiding excessive alcohol, taking medications on schedule, and managing stress all reduce seizure risk. Identifying personal triggers (sleep deprivation, missed doses, illness, hormonal changes) is part of every visit.
what to expect
A clear sense of what will happen so you (or your family) can come in feeling prepared.
Write down what you (or the witness) saw, in order. When did it start? What was the person doing? What did the body do — eyes open or closed, head turning, arm or leg movements, breathing pattern? How long did it last? What was the person like afterward — alert, confused, sleepy? Even a phone video of an event is enormously helpful. Bring a current medication list, including supplements.
We review the story carefully and perform a neurological exam. Most patients are sent for an EEG and an MRI of the brain, plus baseline blood work. We discuss safety — driving, swimming, working at heights, cooking, bathing — and we make a plan for what to do if a seizure happens before our next visit.
You leave with a written plan and clear instructions for medication, follow-up timing, and safety. Many patients can do follow-up visits by telemedicine for medication checks and side-effect review. We are also available by phone (661 857-7100) for questions between visits.
safety
Most people with epilepsy live full lives with appropriate precautions. Here are the practical points we cover with every patient.
California law requires reporting and a defined seizure-free interval before driving. We discuss timing with you in detail and document accordingly.
Showers (with a non-slip mat) are generally safer than baths. Avoid bathing alone in a deep tub when seizures are active.
Swim only with a knowledgeable companion, in shallow water, and after seizure freedom is established. Wear a life jacket on boats.
Avoid working at unprotected heights or operating heavy machinery until seizures are controlled. Discuss accommodations with your employer if needed.
The three most common triggers in adults are sleep deprivation, excessive alcohol, and missed medication doses. Building consistent routines around these dramatically reduces risk.
Most children with epilepsy attend regular school and play normally. We provide written instructions for school staff and help families build a Seizure Action Plan.
frequently asked questions
Plain-language answers to questions we hear in clinic — also marked up as structured FAQ data so they can appear in search results and AI summaries.
A seizure is a single event of abnormal electrical activity in the brain. Epilepsy is the medical diagnosis given when a person has had two or more unprovoked seizures separated by at least 24 hours, or one unprovoked seizure with a high likelihood of recurrence. Many people experience a single seizure in their lifetime — for example, due to high fever as a child or severe sleep deprivation — without ever developing epilepsy.
Seizures are broadly classified as focal (originating in one area of the brain) or generalized (involving both sides of the brain from the start). Focal seizures may occur with or without loss of awareness, and may include strange sensations, déjà vu, automatic movements (lip-smacking, hand-fumbling), or local jerking. Generalized seizures include absence (brief staring), tonic-clonic (convulsive), myoclonic (sudden jerks), and atonic (sudden loss of muscle tone) types. Identifying the seizure type guides medication choice.
An EEG (electroencephalogram) is a painless, non-invasive recording of the brain's electrical activity. Small electrodes are placed on the scalp using a conductive paste, and the recording is typically 20 to 60 minutes for a routine study. You will be asked to relax with eyes closed, then to open and close your eyes, breathe deeply for a few minutes, and look at a flashing strobe light. There is no electricity sent into your head — the EEG only records what is already there. Some patients are referred for ambulatory or prolonged EEG monitoring when more recording time is needed.
Yes. Many people with epilepsy have normal MRIs. The MRI looks for structural causes such as a stroke, scar, tumor, malformation, or hippocampal sclerosis, but most epilepsy is not caused by something visible on imaging. Genetic and idiopathic generalized epilepsies, in particular, often have normal MRIs. EEG, clinical history, and seizure semiology all contribute to the diagnosis.
It depends on your seizure type, your EEG, your MRI, the underlying cause if known, and how long you remain seizure-free. Some patients with childhood-onset epilepsy can taper off medication after several years of seizure freedom. Others — particularly those with structural lesions, persistent EEG abnormalities, or certain syndromes — may need lifelong therapy. Decisions about stopping medication are individualized and should never be made without your neurologist.
California requires that all licensed drivers be free of disorders causing lapses of consciousness for a defined period — currently a minimum of 3 to 6 months of seizure freedom in most circumstances, though the DMV may require longer based on the case. We are also required by California law to report patients who have lapses of consciousness, and we will discuss driving with you openly at every visit. Many patients with well-controlled epilepsy do drive again — but the law and safety come first.
SUDEP — Sudden Unexpected Death in Epilepsy — is a rare but serious risk in people with poorly controlled epilepsy, particularly nocturnal generalized tonic-clonic seizures. Risk is meaningfully reduced by achieving seizure freedom on medication, by taking medications consistently, by avoiding sleep deprivation and excessive alcohol, and (for some patients) by considering nighttime seizure detection devices. We discuss SUDEP openly with patients who have ongoing seizures so they can make informed decisions.
Yes. Dr. Kurian is board-certified in adult and pediatric neurology and sees children with seizures, febrile seizures, absence epilepsy, juvenile myoclonic epilepsy, and other pediatric epilepsy syndromes. Our office is set up for kids of all ages, and family members are encouraged to be in the room during the visit.
Stay calm, time the seizure, ease the person to the floor if they are not already there, turn them onto their side, place something soft under their head, and clear sharp or hard objects out of the way. Do not put anything in their mouth and do not try to restrain their movements. Stay with them until the seizure ends. Call 911 if the seizure lasts more than 5 minutes, if a second seizure follows the first, if the person does not return to baseline after about 20 minutes, if they are pregnant, injured, or have diabetes, or if it is the person's first known seizure.
before scheduling
Many patients call before scheduling — wanting to know whether their concern is appropriate for our practice, what insurance we accept, or how to send records in advance. Our front desk is happy to walk through any of that. We are open Monday through Friday, 9 AM to 5 PM (closed for lunch 12:30 to 1:30 PM) at (661) 857-7100, or send a message through the contact form at any time. Same-day or expedited visits are sometimes available for urgent neurological concerns — please let the front desk know what is happening so we can do our best to fit you in. For new patients, please have your insurance information, primary care physician's name, and a brief description of your concern ready when you call. We verify benefits in advance so there are no surprises at check-in. Existing patients can also reach us through the patient portal for non-urgent questions between visits.