Epilepsy Center for Excellence: Improving Standards of Care
According to Dr. John Hixson, approximately one in ten individuals will have a seizure within their lifetime. Anyone can have a seizure, whether it be provoked by body conditions such as low sodium levels or excessive alcohol consumption, or more permanent genetic mutations, brain structure abnormalities, etc.
In visiting the Epilepsy Center of Excellence at the San Francisco VA Hospital yesterday, the BIE cohort learned about the current standard of care in treating epilepsy patients. Epilepsy is characterized by two or more unprovoked seizures, and affects anywhere from 1–2% of the population. Dr. Hixson described that although physicians have identified many root causes of epilepsy, a majority of seizures are idiopathic, meaning that their causes are unknown.
We learned that a main challenge in the treatment of epilepsy is diagnosing the type(s) of patient seizures. The current “gold” standard involves monitoring a patient in-hospital for anywhere from 3–7 days, with the goal of observing a seizure as it occurs. Outside of this method, physicians must rely on widely variable patient accounts.
Although epilepsy monitoring devices have begun to make advances in the field, there are many improvements still to be made. For example, smart systems that monitor muscle movement, electrodermal activity, heart rate, etc, may completely miss the onset of more passive symptoms. And what about treatment options? There are approximately 30 types of medications, several device based therapies, and a few surgical alternatives. However, even in perfect conditions, the best of these methods is only about 70% effective in preventing seizures.
As we left the Epilepsy Center for Excellence, I was in awe of two things: (1) how many new tools for epilepsy diagnosis and treatment have been constructed and improved in the last twenty years, and (2) how much further there still is to go.
