University of Washington Regional Epilepsy Center at Harborview Medical Center

Neuroimaging

Neuroimaging procedures, especially MRI techniques, are essential tools for investigating the causes of seizure disorders. Improvements in MRI have allowed the detection of subtle anatomical lesions in patients who were previously regarded as having unexplained epilepsy. In people who are candidates for surgical treatment, detection of such subtle lesions, in combination with physiological data from EEG monitoring and PET scanning, results in more reliable localization of the seizure site. Another new technique, functional MRI, has potential for locating essential functions that must be spared in surgical resection. In the future, functional MRI may reduce the need for more invasive techniques of functional mapping such as cortical stimulation, evoked potentials and Wada angiography. Neuroimaging will be one of the most important areas of epilepsy research in the next decade.

Neuropsychology

Many people with epilepsy report problems in memory and mood that affect important areas such as employment. The opportunity for neuropsychological testing is available to everyone coming to the Regional Epilepsy Center. This individualized testing provides a systematic assessment of cognitive abilities and of adjustment. It also helps to set expectations and to make plans for the future. Testing is very thorough and typically takes a full day or more.

When surgery for epilepsy is being considered, these tests are an integral part of the presurgical evaluation. Identification of particular neuropsychological deficits may aid in localization of the epileptic focus and in determining rehabilitation outcome. Wada angiographic testing is also performed to help locate speech and memory functions. Testing after surgery is also possible to determine any changes that may have occurred.

The Epilepsy Conference

Uncontrolled epilepsy is among the most difficult and challenging human disorders. This problem deserves the focused attention of experts who work together in groups to identify and design the best treatment for each individual. For this reason, patients with particularly challenging seizure problems, including all who are evaluated for epilepsy surgery, are reviewed at a weekly conference of all members of the Regional Epilepsy Center. Each patient's history, physical findings and the results of all diagnostic procedures are reviewed. Treatment decisions are made by consensus of the entire group. This interchange of experience and ideas ensures the highest quality of patient care and serves as an important mechanism for providing the most up-to-date treatments based on fundamental epilepsy research.

Contact Information

All patients will be seen initially by one of the adult or child epileptologists of the epilepsy centers, who work with the referring physician to determine an appropriate treatment plan.

Adult patients can be referred to the Regional Epilepsy Center by calling (206)744-3576 or toll-free, 1-800-374-3627. Pediatric patients can be referred to the Children's Comprehensive Epilepsy Center by calling (206)987-2081.