Epilepsy Center of Excellence at the San Francisco VA Health Care System | Honoring America’s veterans with quality epilepsy care
Part of the San Francisco VA Health Care System, patients experiencing reoccurring seizures are seen by the doctors at the Epilepsy Center of Excellence (ECoE). First established in 1997, the ECoE now provides excellent epilepsy care to veterans of the southwest United States. While providing the gold standard diagnosis and treatments for their patients, the doctors make sure to spread greater awareness about epilepsy and reduce stigmas surrounding the condition.
The BIE Gold Team started off their day with Doctor John Hixson, a neurologist well experienced in treating epilepsy and interested in the use of mobile health to improve long-term care within patients with epilepsy. After brief introductions, he gave us an overview of epilepsy, including discussion about the causes of epilepsy, the various types of seizures as well as the prevalence of epilepsy. We then dived into how epilepsy is diagnosed; through CT scans, MRIs with and without contrast agents, and finally the gold standard, EEGs. Dr. Hixson was well acquainted with the difficulties of even diagnosing a patient even with this gold standard, and strongly emphasized the need to acquire data about the patient’s seizures in different ways, not only through video and sound, but also through other signals such as heart rate fluctuations and electrodermal changes. Current state-of-the-art treatments of epilepsy was a hot topic, and to cater to the personal design interests of the members of BIE, we muddied ourselves with the details of Vagus Nervous Stimulation and Responsive Neurostimulation methods used today, as well as other ways of gathering data to diagnose patients and monitor their condition through wearable technology as a future possibility.
Our day ended with a tour of the EEG monitoring facility at the ECoE, which consisted of four stations allowing nurses to monitor and record patients 24/7. Dr. Hixson gave BIE a crash course on what he looks for when diagnosing someone from the results of an electroencephalogram, and left us with the final note, current methods of diagnosis and treatment are neither sensitive nor specific enough, especially as epilepsy can present itself in large variety of ways.
