Epilepsy
- assesment and diagnosis of patients with epileptic seizures and conditions mimicking seizures
- appropriate medical treatment of epilepsy and related disorders
- EEG testing to accurately pinpoint the seizure type and focus continuous video EEG telemetary monitoring for diagnosing difficult epilepsy problems
- clinical pharmacy service
- neuropsychlogical assesment
- brain surgery for patients with seizures not controlled with medications
- vagal nerve stimulaton for certain intractable epilepsy patients
Our epilepsy clinics are run by physicians and other professionals with specialised training in the field. Many are nationally and internationally recognised leaders in epilepsy. Currently, more than one thousand active patients attend our clinics.
If you have any further questions regarding our epilepsy services, please contact any of the following:
S
Receptionist: 984-4760
Nurse Coordinator: 984-4782
Chief Technologist: 984-4763
Faculty
Dr. Mecheri Sundaram:
Clinical Professor of Neurology, and Director of the Comprehensive Epilepsy Center
Dr. Vedanarayanan:
Professor of Pediatrics and Neurology
Dr. Johnathan Fratkin:
Associate Professor of Pathology, head of Neuro-pathology
Dr. Victor Dostrow:
Clinical Associate Professor of Neurology and Pharmacology
Dr. John Norton:
Associate Professor of Psychiatry and Neurology
Dr. Edward Manning:
Clinical Associate Professor of Neurology, Neurophychologist
Dr. Razvan Buicic:
Associate Professor of Radiology, Associate Professor of Neurology and Neurosurgery, director of Neuro-radiology
Dr. John Lancon:
Clinical Associate Professor of Neurosurgery
Information for Patients
General
Epilepsy is a common disease of the brain and affects 1% of the population. There are approximately 25, 000 patients in Mississippi with epilepsy. Approximately 70-80% of patients with epileptic seizures are helped with one or more medications. Many of the remaining 20-30% of patients with epilepsy may be helped with brain surgery or newer surgical procedures.
Medications
Commonly used medications are phenytoin (dilantin), carbamazepine (tegretol), valproic acid (depakote), topiramate (topamax), lamotrigine (lamictal), and galapentin (neurontin). Some of the older medications include phenobarbitals and primidone. These medications may have side affects such as drowsiness, dizziness, and double vision, but these side effects often improve with time. Serious side effects from medications are extremely rare; however they may not be predictable. One of the reasons for medication failure is not taking the medication as prescribed by the physician or missing the dosage. If you have any questions about your medications, discuss them with your physician or pharmacist.
EEG
This is used for accurately diagnosing the type of epileptic seizure and finding the area(s) of the brain from which the seizure arises. The test is done by placing several electrodes on the scalp skin and recording the electrical activity from the brain for 20-30 minutes. The entire procedure takes approximately 60-90 minutes. Sometimes, a single EEG may not show the abnormal signal, and your doctor may order more EEGs for picking up the abnormal signals. The procedure is harmless and does not have any serious side effects.
Video EEG Telemetry
This is a continuous recording of the brain activity over several hours or days. This is done when routine outpatient EEG has not provided information for when surgical treatment is contemplated. A video camera is also used to analyse physical changes that may take place during an epileptic seizure.
Surgery for Epilepsy
Approximately 20-30% of patients with epilepsy do not respond to currently avaiable medications. Many of these patients may be helped or even cured by removing a small part of the brain that is responsible for the seizures. Video EEG telemetry is usually performed to record several seizures to pinpoint where the seizure focus is. This involves staying in the hospital for several days. Once the seizure focus is clearly defined, the neuropsychologist performs basic memory testing to ensure that the patient's memory is adequate for proceeding with surgery. Once the preliminary memory testing is completed, an outpatient procedure called wada testing is done to decide how much memory is contained in each half of the brain-this information is crucial for decided whether to proceed with surgery and how much brain tissue needs to be removed at the time of surgery. The wada test is an outpatient procedure and is done under X-ray control. The patients for the wada test are generally asked to arrive first thing in the morning, at approxomately 7 am and are sent home around 4pm. The actual brain surgery for epilepsy generally lasts about six to eight hours. Most of our patients are discharged in four or five days after the surgery. Routine activities can be resumed within one or two weeks of surgery. There are different types of brain surgery performed for interactiable epilepsy. The commonly performed procedure, called "temporal lobectomy" usualy carries an 80-90% chance of cure or significant seizure reduction. Risks from brain surgery for epilepsy are small and may include unexpected brain swelling, infection, bleeding, weakness on one side of the body, and speech difficulties. The neurosurgeon will explain these issues prior to the operation. The chances of serious risk from epilepsy surgery are around 1 or 2 percent.
Neuropsychology Services
The neuropsychologist does a memory assesment and also assists in managing patients with a type of seizure called a "pseudoseizure".
Research in Studies with Potential Medications
We are actively involved in testing several potentially useful medications in a number of adults and children with epilepsy. We are one of the select national centers for doing such research. If you need additional information about ongoing research studies, please call our nurse coordinator.
Appointments
For further information about appointments, please call one of the following:984-4760 (Receptionist)
984-4763 (Chief Technologist)
984-4782 (Nurse Coordinator)