Epilepsy is a chronic brain disorder that manifests with seizures. It is the fourth most common neurological disorder. The causes of epilepsy are numerous and include stroke, brain tumor, head injury, genetic disorders, brain infection or other neurologic conditions. For a subset of individuals with epilepsy, no clear cause can be determined.
Seizures are the result of abnormal electrical activity of brain cells that can lead to loss of awareness with or without associated involuntary movements. People are diagnosed with epilepsy when they experience two or more unprovoked seizures (or one unprovoked seizure with the high likelihood of more) that are unrelated to other reversible medical problems, such as high fever, alcohol withdrawal or very low blood sugar.
Seizures can be divided into two main categories depending on how they start in the brain: generalized and focal seizures.
- Generalized seizures affect both sides of the brain and cause a person to have facial contractions, rapid blinking and muscle stiffness with limb jerks.
- Focal seizures start in one area in the brain and can cause a variety of symptoms or body manifestations depending which brain area is involved.
About 3 million people in the United States have epilepsy, according to the Centers for Disease and Control Prevention, and 1 in 26 people in the United States will develop epilepsy at one point in his or her life.
UK HealthCare’s Comprehensive Epilepsy Program provides specialized care to children, adolescents and adults living with epilepsy. Our epileptologists are neurologists trained to help those diagnosed with epilepsy follow a personalized treatment plan to manage their specific needs. They work closely with other specialized colleagues such as neurosurgeons, neuropsychologists and neuroradiologists in a multidisciplinary fashion.
Seizures are disruptive to the lives of those they affect and their loved ones. Certain seizures cause injuries and even death (known as Sudden Unexpected Death in Epilepsy or SUDEP). It’s critical that the type of epilepsy and the source of the seizures be identified as quickly as possible so treatment to control and manage symptoms can begin.
The International League Against Epilepsy (ILAE) has defined drug resistant or medically resistant epilepsy as when a person with epilepsy is unable become (and stay) seizure-free despite adequate trials of two anti-seizure medications (also known as antiepileptic drugs) that are appropriately chosen and dosed. It is recommended that these patients be referred to a comprehensive epilepsy center.
The Comprehensive Epilepsy Program at UK HealthCare offers the latest monitoring technologies, including specialized brain imaging, functional MRIs, and in-depth brain testing and brain mapping to help determine where in the brain seizures are occurring.
Our adult and pediatric epilepsy monitoring units use video-electroencephalogram testing to help the treating team determine the type of seizures and the parts of the brain involved by the seizure activity.
UK HealthCare has been named the No. 1 hospital in Kentucky by U.S. News & World Report, and the Neurology and Neurosurgery department received top 50 national ranking.
The Kentucky Neuroscience Institute (KNI) is accredited by the National Association of Epilepsy Centers (NAEC) as a level 4 center. Level 4 epilepsy centers offer the most advanced monitoring, testing and treatments for complex types of epilepsy. The multidisciplinary team and epileptologists at our center are experts in treating those with drug-resistant epilepsy or uncontrolled seizures.
The adult epilepsy monitoring unit (EMU) offers six private rooms in Pavilion H (7th floor West wing). The pediatric EMU offers three private pediatric rooms in pavilion H (3rd floor North wing). The EMU offers prolonged combined data from the EEG and concomitant video. This data helps the neurologist determine what type of seizures the patient is experiencing, which helps tailor treatment. This data also provides information about where seizures originate in the brain. This is a key step to evaluate if patients are candidates for epilepsy surgery.
Potential therapeutic options such as new anti-epileptic drugs and epilepsy surgery are determined for each patient. Some patients are followed long-term in the Epilepsy Clinic, while most are returned to their primary neurologist for ongoing care.
Our services include diagnostic testing and the latest treatments for the management of all forms of epilepsy. We provide outpatient services as well as inpatient care with the latest diagnostic monitoring equipment, including:
- Specialized MRI procedures
- Intra carotid sodium amytal procedures (WADA tests)
- Ictal and inter-ictal SPECT studies
- Intra-operative mapping with awake craniotomy
Consultative services such as neuropsychology evaluations and neurosurgical evaluations are available. Potential therapeutic options such as new anti-epileptic drugs, innovative treatments, VNS therapy, ketogenic diet and epilepsy surgery are determined for each patient.
New referrals, established patients and individuals enrolled in clinical trials are all seen in the epilepsy clinic.
Adult patients undergoing phase I monitoring (noninvasive video-EEG monitoring) and phase II (invasive) monitoring are hospitalized in the EMU. Outpatient ambulatory EEG studies are offered through the UK EEG laboratory.
If you or someone you care about is living with epilepsy and continuing to experience seizures, even with treatment, you may want to consider participating in a clinical research trial. Without these research studies, we would be unable to provide new drugs and medical devices to benefit others living with epilepsy.
We have ongoing clinical trials involving epilepsy and anti-epileptic medications for infants, children and adults. We are extensively involved in research, both at UK and in collaboration with other prominent epilepsy centers regionally and nationally.
Rachel Ward-Mitchell, RN, epilepsy nurse coordinator
Rachel Ward-Mitchell has been a nurse at UK since 2004 and spent seven years working in the Epilepsy Monitoring Unit. In 2011 she shifted her role to act as the nursing resource coordinator for the UK Comprehensive Epilepsy Program.
She assists patients through first diagnosis, ongoing treatment, clinic visits, hospital stays, diagnostic testing, surgery, medication side effects and psychosocial aspects associated with epilepsy. She works closely with the local Epilepsy Foundation affiliate to advocate, educate and find community resources for patients.
Micah Philpot, Comprehensive Epilepsy Program patient services coordinator
Micah Philpot is patient services coordinator for the comprehensive epilepsy program at UK. He has been with UK for 10 years in a variety if administrative roles for the UK Neurology and the Kentucky Neuroscience Institute.
He is responsible for the epilepsy clinic schedule, EMU hospital admissions and coordinating special procedures and diagnostic testing.
“I’m Not Afraid of Anything”
Charlotte Ard suffered from seizures as long as she can remember. Her seizures were frequent and sometimes dangerous. After seeing her regular doctor for many years without improvement or answers, Charlotte knew it was time to seek help somewhere else.
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