Complex Case Conference: Epilepsy

Complex Case Conference: Epilepsy

Is epilepsy surgery right for your patient?

Paul V. Motika, M.D., Medical Director,
Adult EEG, OHSU Comprehensive
Epilepsy Center

The OHSU Comprehensive Epilepsy Center offers surgical treatment for complex epilepsy cases.

Patients with medically refractory epilepsy may benefit from one of several surgical treatments, including vagal nerve stimulation, selective amygdalohippocampectomy, anterior temporal lobectomy and lesionectomy. The OHSU Comprehensive Epilepsy Center provides a comprehensive evaluation with a multi-modality, multi-disciplinary approach.

Recognized by the National Association of Epilepsy Centers as a Level 4 Epilepsy Center, the OHSU Comprehensive Epilepsy Center offers the professional expertise and facilities to provide the highest level medical and surgical evaluation and treatment for patients with complex or refractory epilepsy. The center treats a high volume of patients with refractory epilepsy and performs a significant number of epilepsy surgeries every year for adults and children.

Evaluation and collaboration
All candidates for epilepsy surgery undergo a thorough assessment, including inpatient continuous EEG monitoring for localization and characterization of seizures, imaging studies (such as high resolution MRI, PET, SPECT and MEG), and potentially more complex and invasive techniques such as foramen ovale or intracranial electrode implantation and intraoperative electrocorticography. Neuropsychological assessment is also an important component of the evaluation.

OHSU holds epilepsy surgery conferences at least monthly, involving the entire epilepsy team (neurologists, neurosurgeons, radiologists, nurses and staff). The team reviews each patient and his or her evaluation in detail, and makes recommendations as to what surgical approach could be offered and if appropriate.

Even if patients are not suitable candidates for surgery, the Epilepsy Team may suggest other treatment options, such as recommendations for non-surgical therapy or clinical trial involvement.

Additional therapies
In addition to evaluations for surgical interventions, our specialists can also offer expertise in the medical management of complex epilepsy as well as management of co-morbid conditions. The OHSU Epilepsy Center is also actively involved in a number of cutting-edge research projects in which patients may wish to participate. These include clinical trials for the evaluation of exciting new anti-epileptic medications, as well as devices such as NeuroPace Cortical Stimulator.

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