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At the UW Medicine Regional Epilepsy Center, based at Harborview Medical Center, teams of specialists in adult and pediatric neurology, neurosurgery, neuroradiology and neuropsychology, as well as nurses, social workers, vocational rehabilitation specialists and electrodiagnostic technicians, diagnose and treat difficult seizure problems.

UW Medicine's Regional Epilepsy Center offers a system-wide, integrated, multidisciplinary program for the comprehensive clinical care of epilepsy, including conventional, as well as new, innovative electrodiagnostic and brain imaging methods to correctly diagnose seizures and determine their underlying cause.  The center also works in partnership with referring physicians across the Northwest and the rest of the United States to diagnose and treat all types of seizure disorders among children and adults.

Care for all types of uncontrolled epilepsy

Chronic recurrent seizures (epilepsy) impact the lives of more than 2.5 million people in the United States. While primary care and emergency physicians often initially diagnose and treat epilepsy, referral to a neurologist may be considered if seizures are not controlled within three months. If seizures cannot be controlled within one year, referral to a specialty epilepsy center is usually recommended. Epilepsy centers affiliated with a university medical school have capabilities in diagnosing and treating all types of uncontrolled epilepsy and offer care for the most complex and difficult seizure problems.

Fortunately, most people with epilepsy eventually respond to treatment and can return to normal lives. Newly developed treatments and surgery make it possible to control seizure disorders once thought to be untreatable. However, many who could be helped with these treatments are not currently receiving them.

Services include:

  • All conventional medical and dietary treatments
  • New (investigational) antiepileptic drug treatments
  • Neurosurgical treatment
  • Vagus nerve stimulator implantation and management
  • Neuropsychological effects of epilepsy on neurocognitive and emotional functioning
  • Education, counseling, and job placement.
  • Wada assessments to determine lateralization of speech and memory.

If you have questions about our services, please contact us via e-mail: epilepsy@u.washington.edu or by phone: 206-744-3576.  Or phone toll free: 1-800-374-3627 (1-800-EPI-DOCS)

Directions to Harborview Medical Center



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Surgical Treatment of Epilepsy
Providers: Cheng-Hakimian, Andrea L., Hakimian, Shahin , Hebb, Adam O., Holmes, Mark D., Miller, John W., Oakley, John C., Ojemann, Jeffrey G., Poolos, Nicholas P., Swanson, Phillip D., Wilensky, Alan J. Last Updated: Friday, March 21, 2008

About 1/3 of patients with epilepsy cannot be adequately controlled by antiepileptic medication. Some of these patient can achieve seizure control by removal of the part of the brain that is causing the seizure. This is called epilepsy surgery. The surgery is done to get rid of the seizures. The purpose of the surgery is not to get off of antiepileptic medication, because many patients with successful epilepsy surgery still have to take medication to stay seizure free.

Epilepsy surgery is a possibility under these conditions:

  1. It has to be clear that there is very little chance that seizures can be stopped with medication. This typically means that trials of several medications which are appropriate for a patient’s epilepsy type have failed to control the seizures. It doesn’t count if a medication couldn’t be given an adequate trial because a patient couldn’t tolerate it. The number of medications that should be tried may depend on what type of epilepsy a person has, and its cause. 
  2. The seizures have to be disabling. This isn’t measured by the number of seizures, but by how much they interfere with a person’s life. 
  3. The person needs to understand the risks and possible benefits of the surgery. This is elective surgery, that a person decides to undergo to try to get rid of their seizures. The chance of being seizure free after surgery can be anywhere from 40-90%, depending on the type of operation and the cause of the epilepsy, and other details of a patient’s condition. Although many studies show about a 4% risk of complications from the operation, the risk also depends on many factors, including a patient’s general health, and the exact operation which is performed. 
  4. It has to be determined where the seizures come from. The person has to have partial (focal) or secondarily seizures, and the EEG recordings and neuroimaging has to clear show the region where the seizures start (the “seizure focus”). 
  5. It has to be shown that it is safe to remove the seizure focus, and that taking it out does not have a serious risk of significantly affecting essential functions such as memory, language or movement. Tests such as the Wada test, fMRI, and functional mapping of the brain by electrical stimulation in the operating room or during invasive monitoring are all used to show if the seizure focus is close to brain areas that mediate important functions.

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