MRI-laser ablation for epilepsy at the University of Washington Epilepsy Program
The Regional Epilepsy Center at Harborview, and the Epilepsy Center at Seattle Childrens Hospital have introduced the Visualase System, a MRI-guided, minimally invasive laser ablation system for treatment of epilepsy and other brain lesions to the Pacific Northwest. This system is FDA-cleared for ablation of brain regions, and is especially useful for removal of structures causing epilepsy, such as hypothalamic hemartomas, and the hippocampus in many individuals with mesial temporal lobe epilepsy. This minimally invasive technique allows treatment of deeper brain structures with little injury to overlying brain areas that are not involved in the epilepsy. Discomfort to patients is greatly reduced, and they most often only have to stay in the hospital overnight.
This system delivers light energy to the target through a small needle introduced through a 3.2 mm hole in the skull, which is directed to the target under stereotactic guidance. The laser produces elevation of the temperature at the end of the needle, destroying the unwanted tissue. The procedure is done in the MRI scanner, using imaging methods that measure temperature changes, so that the ablation size can be monitored and controlled in real-time.
This approach offers significant advantages for surgical treatment of certain types of epilepsy. It is performed by Dr. Jeffrey Ojemann at both Harborview Medical Center and Seattle Childrens Hospital.
Dr. Ojemann expains MRI-laser ablation
Responsive neurostimulation at the University of Washington Epilepsy Program
The U.S. Food and Drug Administration has granted approval for the NeuroPace® RNS® System, to treat seizures in adults with drug resistant focal epilepsy. This device is designed to detect abnormal electrical activity in the brain and respond by delivering electrical stimulation to stop seizures. This involves implanting electrode over or in the brain to detect and respond to seizures, and the RNS neurostimulator, which is a programmable microprocessor-controlled device that detects the abnormal electrical activity and delivers the electrical pulses. This device has been shown in a published clinical trial to reduce seizures in some patients. The most appropriate candidates for this treatment may be individuals with well localized epileptic foci who are not candidates for removing the abnormal tissue because it is on both sides of the brain, or in a brain area that cannot be removed because of risk to important functions such as movement or language.
The EEG laboratories at Harborview Medical Center, the University of Washington Medical Center and Seattle Childrens hospital are accredited by the Laboratory Accreditation Board of the American Board of Registration in Electroencephalographic and Evoked Potential Technologists (ABRET). This is a recognition of the efforts of the laboratories to ensure competency and excellence in clinical neurophysiology. The EEG laboratory at Harborview performs approximately 4,000 studies a year, and provides clinical neurophysiology services for the Regional Epilepsy Center.
"Mild passive focal cooling prevents epileptic seizures after head injury in rats," a joint project between investigators at UW, the University of Minnesota, and Washington University in St. Louis, has been featured in UW Today. Using a rat model, the investigators found that cooling the brain after a traumatic head injury inhibits the onset of epileptic seizures. The study was reported in the Annals of Neurology.
New Faculty Announcement
Dr. Norman So
The Regional Epilepsy Center is pleased to welcome Dr. Norman K. So. Dr. So is a new Clinical Professor of neurology at the University of Washington. He arrives from the Cleveland Clinic Epilepsy Center. Dr. So received a B.A., M.A. and his medical degree from the University of Cambridge. He is board certified by Royal College of Physicians, U.K. and is certified in the U.S. in Neurology, Clinical Neurophysiology, Sleep Medicine and Epilepsy. He did his neurology residency at the Mayo Clinic, and completed a fellowship in EEG and Epilepsy at the Montreal Neurological Institute. He has previously worked at the Cleveland Clinic Epilepsy Center, and has directed the Oregon Comprehensive Epilepsy Center in Portland, OR. He has served as medical director of neurology services for the Legacy Portland Hospitals. He works at both Harborview Medical Center and the University of Washington Medical Center. He has particular interest and expertise in clinical EEG and the surgical treatment of epilepsy
New Faculty Announcement
Dr. Andrew Ko
The Regional Epilepsy Center is pleased to welcome Dr. Andrew Ko, who is a new Assistant Professor of Neurological Surgery at the University of Washington. Dr. Koearned his medical degree from the University of Illinois and completed his neurosurgery residency at the UW. He rejoined the UW faculty after completing a fellowship in Functional and Stereotactic Neurosurgery at the Oregon Health & Sciences University. His clinical specialties include surgery for epilepsy, movement disorders and pain. His clinical specialties emphasize the use of stereotactic techniques that are precise, minimally invasive and non-destructive. Some examples include stereotactic laser ablation for epilepsy, and image-guided, frameless deep brain stimulation for Parkinson's disease and other movement disorders. His research interests include cortical electrophysiology and brain-computer interfaces; the development of novel imaging targeting techniques and patient-responsive deep brain stimulation.