Quality Patient Care

At the Regional Epilepsy Center, quality care is our first priority.

Our staff at the UW Medicine Regional Epilepsy Center strives to provide the best possible care by working together as a team. All patients receiving inpatient care for epilepsy diagnosis or possible neurosurgical treatment are discussed twice a week at our epilepsy conference. This way, members of our faculty and staff can share their diverse experience and expertise as we form patient treatment plans.

Our Team of Specialists

Community neurologists can provide excellent care for most patients with epilepsy. However, treatment of the most difficult seizure problems may require a team of specialists, especially when brain surgery is an option to treat uncontrolled epilepsy. At the Regional Epilepsy Center this team includes:

• Epileptologists: Neurologists with fellowship training and specialization in epilepsy.
• Epilepsy Neurosurgeons: Neurosurgeons with fellowship training and specialization in surgery to treat epilepsy.
• Neuropsychologists: Trained in assessing cognition and memory in patients with epilepsy.
• Psychometrists: Technicians who assist neuropsychologists in performing neuropsychological testing and Wada tests.
• Vocational Rehabilitation Specialist: A certified rehabilitation psychologist who helps epilepsy patients rejoin the workforce.
• Psychiatrist: Specializing in depression and other emotional disorders experienced by some patients with epilepsy and other episodes.
• Social Workers: Specializing in the psychosocial needs of patients with epilepsy, including medication assistance.
• Epilepsy Nurses: Specialists in epilepsy with experience in recognizing and reacting to seizures, and the effects of seizure medications.
• Physician Assistant: Specializes in the outpatient and inpatient care of epilepsy under the supervision of an experience epileptologist.
• Epilepsy Electrodiagnostic Technologists: Registered technologists with training and experience performing long-term video EEG monitoring, and performing EEG and evoked potential studies in the operating room.
• Epilepsy Fellow: Fully trained, board-eligible neurologist receiving training in epilepsy care.
• Neuroradiologist: With expertise in interpreting MRI and angiography in patients with epilepsy.
• Nuclear Medicine Specialist: With expertise in interpreting ictal and interictal SPECT.
• Neuropathologist: A pathologist with expertise in interpreting surgical specimens from epilepsy surgery.

Our Faculty

All neurologists, neurosurgeons and neuropsychologists are faculty in the UW School of Medicine. Faculty have special fellowship training and expertise in treating epilepsy, along with special interest, expertise and research accomplishments in particular aspects of epilepsy assessment or treatment.

Credentials

All faculty are board certified in their specialty, or, if they have recently completed training, are required to pursue certification. In our main inpatient epilepsy monitoring unit at Harborview medical center, all hospitalized patients are cared for by board certified neurologists and all long-term video EEG monitoring studies are interpreted by neurologists with board certification in EEG and clinical neurophysiology. All outpatient physicians at Harborview are also board certified in neurology or neurosurgery. Verifying credentials

Facility and Patient Safety

Inpatient care is provided at Harborview Medical Center which has a 10-bed epilepsy monitoring unit with the newest and best available EEG equipment. Patients are admitted to the monitoring unit where staff record their seizures. Often patients' seizure medications are reduced to bring on seizures. To ensure our patients’ safety, they are under continuous closed circuit TV (video) observation by trained epilepsy technicians 24 hours a day, seven days a week.

If patients have a seizure, the monitoring technicians push an alarm, and trained epilepsy nurses enter the room to observe the seizure, protect the patient from injury and stop the seizure with intravenous medication, if needed. Although not all epilepsy centers do this, we believe having hospital staff watch patients continuously on video is the best way to ensure patient safety in the event of seizures.

Harborview Medical Center cares for the largest number patients with acute neurological problems and emergencies in the region. As a result, our neurology/neurosurgery nurses and staff on the epilepsy/neurology unit and in the operating room are very experienced. 

Research

Epilepsy is a complex medical condition, and our understanding of its causes is incomplete. For some patients with severe, uncontrolled epilepsy, treatment may not be adequately effective. Therefore, we strive to better understand epilepsy and its treatment through clinical and laboratory research.

We have one of the most productive active research programs in the United States, because of the skills and knowledge of our faculty and because we are part of the UW School of Medicine. Research studies are always optional, and we certainly understand that some patients will decline to participate. Nevertheless, we believe that research makes us better clinicians, and helps us to better treat seizures, even in those patients who are not in a research study. The Regional Epilepsy Center was the first epilepsy center to use dense array EEG to localize seizures in patients being evaluated for epilepsy surgery. This method is now being adopted by other large epilepsy centers and is being introduced into clinical practice.

Training Programs

Training residents and fellows in epilepsy is part of our mission to the community. In addition to residents in neurology who may spend time on our epilepsy service, we have an accredited program in clinical neurophysiology to train the next generation of epilepsy specialists in EEG and related techniques. After a year of training, fellows typically spend one or two more years training in epilepsy care and research. The Department of Neurosurgery also has a fellowship program in epilepsy surgery. Physicians we have trained work at epilepsy centers throughout the world.

Our training program gives us several advantages. We believe that having the responsibility of educating bright, intelligent residents and fellows makes us better doctors and improves patient care. We also have the opportunity to invite the very best of the physicians finishing our fellowship program to join the Regional Epilepsy Center as UW faculty.

Patients in our center are always cared for by attending physicians/university faculty. Only a very small percentage of outpatients are seen by residents, and these patients will always also be seen and examined by the attending physician, who is responsible for all decisions and follow-up care. On the inpatient units, patients may sometimes be seen by residents or fellows, but the attending physician will also see and examine each patient each day and make all decisions.

Experience

Because the UW Medicine Regional Epilepsy Center was established more than 30 years ago, many of our neurologists and neurosurgeons have decades of experience in treating epilepsy. Because we are the largest epilepsy treatment center in the region, we have experience in treating the most rare and most difficult forms of epilepsy. We especially value the continuing presence of Dr. George Ojemann, one of the most experienced and renowned epilepsy neurosurgeons in the world. His surgical experience includes more than 1,000 brain resections to treat uncontrolled epilepsy. Although he is retired from the operating room, he continues to share his advice and wisdom in epilepsy conferences.

Timely Care

When patients suffer a new onset of seizures, or a patient with seizures experiences a period when seizures go out of control, they cannot safely wait weeks to get an appointment with an epilepsy specialist. When physicians in the community need to transfer a patient for monitoring and treatment of uncontrolled seizures, they also need prompt action. Our center is organized and staffed to deal with these situations. Because our inpatient epilepsy monitoring unit has the capability of monitoring up to 10 patients, we typically can arrange for urgent hospital admissions as needed. We also have six treating epileptologists at Harborview alone, and the epilepsy center outpatient clinics see 300 to 350 adult patients each month.

Most of the time, we are able to see new patients in the clinic within one to two weeks. However, during those times when the wait may be longer, we will monitor the situation and make special arrangements to see patients with urgent medical needs more quickly. As such times, we request that referring physicians call our center at 206.744.3576 so we can arrange for admission to our satellite monitoring unit at UW Medical Center or make other special arrangements.

Communication with Patients

A key to excellent epilepsy care is good two-way communication between patient and their health care providers. We emphasize communication and education during visits with out neurologists and neurosurgeons in the clinic, and we encourage patients to ask questions and share their concerns freely and openly.

It is even more important that patients be able to call and get help when seizures occur unexpectedly or unexpected medication side effects occur. We are very fortunate to have friendly, dedicated and experienced full-time resource nurses who are readily accessible during working hours at 206.744.3576. These nurses are constantly in touch with the center physicians and can relay patient concerns and receive treatment recommendations in a timely manner. After hours, calls are handled by the Harborview Community Care Line, but there is always an attending epilepsy center neurologist on call 24/7 to handle urgent issues.

Relations with Community Physicians

The Regional Epilepsy Center works cooperatively with many neurologists in the area. Many patients receive their day-to-day care by a neurologist or epilepsy specialist close to home but come to our center for special tests or treatment. Many of the other epilepsy centers in the region will occasionally refer patients to our center, performing the initial workup before sending the patient to us for additional tests or surgery.

As a service to community physicians and patients with epilepsy, we will analyze EEG monitoring studies, MRIs and other tests previously performed in another facility, and then present the patient at our epilepsy conference for treatment recommendations to be communicated to the referring physician or patient. Typically the data is provided on compact discs. There is no charge for this service, which typically will take two to three weeks to complete.

It is our policy to communicate frequently with referring physicians during inpatient evaluations. This communication includes discharge summaries, copies of tests results, letters summarizing the opinions and recommendations of epilepsy conference, as well as doctor-to-doctor telephone calls.