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The Epilepsy Clinic is held on Wednesday morning at the University
Hospital, Neurology Clinic from 8:00 a.m. to noon. Appointments may be
made by calling Neurology Central Scheduling at (317) 278-5450 or toll
free (866) 740-1941. The clinic prefers that a patient be referred by a
physician, although patients may also call directly for an appointment.
The Epilepsy Clinic provides comprehensive management to patients with
epilepsy through evaluation, medication, surgical treatment, psychiatric
management and psychosocial counseling. Also patients with epilepsy
may be seen by individual epileptologists in private clinics held at
University Hospital, Riley Hospital for Children and Wishard Memorial
Hospital. To make an appointment at University Hospital or Riley
Hospital for Children, call Neurology Scheduling at (317) 278-5450 or
toll free (866) 740-1941. To make an appointment at the Wishard
Epilepsy Clinic, call (317) 630-7004.
Epilepsy Monitoring
Units
There are two Epilepsy Monitoring Units, one at University Hospital (six
beds) and the second at Riley Children’s Hospital (three beds).
Patients with suspected epileptic seizures or episodic phenomena are
continuously monitored by simultaneous video/EEG to confirm the
diagnosis of epileptic seizures, to characterize epileptic seizures, to
classify an epilepsy syndrome, to localize an epileptogenic focus, and
to distinguish epileptic episodes from nonepileptic episodes.
Diagnostics Tests
All types of diagnostic evaluations
of patients with epilepsy are offered at the Indiana University
Comprehensive Epilepsy Center. These include:
Routine Wake/Sleep EEG
MRI scan (including 3 Tesla scans)
Video/EEG monitoring from scalp and sphenoidal electrodes
Neuropsychological testing
Psychiatric evaluation and management
PT scan
SPECT scan (interictal and ictal)
Intracarotid sodium amytal test (Wada test)
Electrocorticography
Invasive intracranial recordings from
Subdural grids
Depth electrodes
Nonepileptic Psychogenic Seizures
Epilepsy Surgery
Patients with epilepsy whose seizures cannot be adequately controlled by
antiepileptic drugs are offered surgical treatment at the IU
Comprehensive Epilepsy Center. Appropriate diagnostic evaluation
precedes surgical management. Appropriate surgical procedures are
decided by a team consisting of epileptologists and the neurosurgeon.
The following epilepsy surgeries are performed at the IU
Comprehensive Epilepsy Center.
Resection of epileptogenic focus
The most common is the anterior temporal lobectomy to treat
medically refractory temporal lobe epilepsy. The success rate is
similar to other comprehensive epilepsy centers in the United States and
abroad. Two-thirds become seizure free and the remaining attain
markedly improved seizure control after anterior temporal lobectomy. The
IU Comprehensive Epilepsy Center has performed anterior temporal
lobectomies since 1984 and has done over 400 surgeries, the only center
with this long and extensive experience in the state of Indiana.
Vagal nerve stimulation
Vagal nerve stimulation is a palliative surgery which is performed in
patients with medically refractory epilepsy who are not suitable
candidates for resective surgery. It is FDA approved. A battery-driven
stimulator is placed in the upper left chest, and the left vagus nerve
is stimulated by thin leads going from the chest device to the mid-neck
region. The IU Comprehensive Epilepsy Center has performed over 200
such surgeries.
Hemispherectomy
Hemispherectomy which is surgical removal of major portions of the
hemisphere, performed in children with extensive unilateral cerebral
lesions resulting in medically refractory epilepsy. major portions of
the diseased half of the brain is surgically removed.
To inquire or to refer a patient for epilepsy surgery, please call the
IU Comprehensive Epilepsy Program at (317) 274-0180 or (800) 210-7123.
Protocol-driven Research and experimental surgical procedures are
also offered at the IU Comprehensive Epilepsy Center. These procedures
include:
Deep brain stimulation
Electrical stimulation of certain deep brain structures by intracerebral
electrodes to control epileptic seizures. This study has been completed
and is not currently enrolling more candidates.
NeuroPace
A new technique to recognize the start of a seizure followed by
electrical stimulation of the appropriate area to stop the seizure
through electrodes placed in the epileptogenic focus
To inquire if you may be a candidate for these experimental surgeries,
call the IU Comprehensive Epilepsy Program at (317) 274-0180 or (800)
210-7123.
Nonepileptic seizures or pseudoseizures
The IU Comprehensive Epilepsy Program has the longest and most extensive
experience in the evaluation, diagnosis and management of patients who
have spells mimicking epileptic seizures. Diagnosis of pseudoseizures
needs to be confirmed by video EEG – the “gold standard” test – before
management can be instituted.
To refer a patient suspected to have pseudoseizures, please call the IU
Comprehensive Epilepsy Program at (317) 274-0180 or (800) 210-7123.
EEG/Epilepsy Fellowship Program
The Department of Neurology of the Indiana University and its
Comprehensive Epilepsy Program offers an ACGME-approved fellowship (1
year) in EEG/Epilepsy to train neurologists (who have completed an
accredited neurology residency) who wish to specialize in the field of
EEG and epilepsy. The program has trained over 60 specialists since
1972. Further information about the fellowship program may be obtained
by calling (317) 274-0311.
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