91ɫƵ

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91ɫƵ Comprehensive Epilepsy Center

Our program provides cutting-edge diagnostic and therapeutic options to patients with epilepsy in all age-groups. A programmatic approach is taken to pursue the goal of seizure freedom without adverse side effects.

Brain with Epilepsy

Since 1991 91ɫƵ Comprehensive Epilepsy Program has specialized in helping people with difficult-to-control epilepsy. Patients from throughout Wisconsin and the upper Midwest receive care through the program – one of the first epilepsy programs in the state. Our goal is to improve patients’ quality of life by controlling their seizures with minimal side effects from medication.

The 91ɫƵ Comprehensive Epilepsy Program takes a multidisciplinary approach to providing care to epilepsy patients in close collaboration with the their primary neurologists and other health care providers. The Departments of Neurology, Neurosurgery, and Neuroradiology, with the research benefits derived from the 91ɫƵ Clinical Research Center and Biophysics Department, carefully tailor treatment to the specific needs of individual patients. Diagnostic options available to patients include Video-EEG monitoring, Ambulatory-EEG, Invasive Intracranial EEG studies, High resolution MR imaging with dedicated epilepsy protocols, Intracarotid Amobarbital Procedures (Wada test), fMRI, SPECT, PET, Magnetoencephalography (MEG), and direct electrical stimulation mapping of the cortex. All currently accepted therapies for epilepsy are available through our program including all anticonvulsants, drugs that are in clinical trials, all types of epilepsy surgery, Vagus Nerve Stimulation, as well as the ketogenic or modified Atkins diets. Our adult program also has extensive experience in catering to the special needs of women with epilepsy, especially those in the childbearing years.

Adult and pediatric components of the program are located in adjacent hospital complexes with separate epilepsy monitoring units and busy, well-established epilepsy surgery programs. The Adult Epilepsy Center based at Froedtert Hospital is also one of a few epilepsy centers in the United States to be certified by the Joint Commission International (formerly JCAHO). The Pediatric Epilepsy Center is housed at Children's Wisconsin. The clinical program is a tertiary referral center for a large region of eastern Wisconsin and northern Illinois.

Drs. Hema Patel, Nadir Khan, Kumar Sannagowdara and Michael Schwabe provide care for children through the Pediatric Epilepsy Center.

Drs. Humberto Battistini, Patrick Bauer, Chad Carlson, Manoj Raghavan and Serena Thompson provide patient care at the Adult Epilepsy Center.

Neurosurgical procedures for our epilepsy program are performed by Drs. Wade M. Mueller, Sean Lew, And Irene Kim. Our neurosurgeons have partnered with our epilepsy specialists in conducting over 300 epilepsy surgeries, of all types, over the last 10 years alone. Our programs have extensive experience with Vagus Nerve Stimulation therapy for the control of seizures with more than 600 implantation procedures over the years.

The Neuropsychology program at 91ɫƵ services provided include comprehensive neuropsychological assessment for patients with epilepsy including those in the epilepsy surgery program or those who have cognitive concerns. In addition, neuropsychology is involved in specialized brain mapping techniques including intracarotid sodium amytal testing, functional MRI language mapping, and intraoperative stimulation mapping.

Providers are Drs. Sara Swanson, Jennifer Koop, Michelle Loman, Laura Umfleet and Julie Janecek as well as our dedicated epilepsy rotation fellow.

The clinical fMRI program at 91ɫƵ is an invaluable asset to the epilepsy surgery program for mapping vital areas of brain function prior to brain surgery, and for predicting language and memory outcome after temporal lobe surgeries. Magnetoencephalography (MEG) which is a new addition to our arsenal of diagnostic tools, not only provides a complimentary methodology to fMRI for function localization, but also allows localization of epileptic circuitry on patient-specific brain models.

The program hosts a monthly support group for patients with epilepsy and their families to provide educational opportunities as well as interactive sessions with various specialists on topics relating to epilepsy.

Our Epilepsy Program has greatly benefited from a strong tradition of translational neuroimaging research which is a particular strength at the 91ɫƵ. Research pioneered at our institution has been central to the development of clinical fMRI for the presurgical evaluation of patients with epilepsy and brain tumors. Other resources available for basic and applied research include a recently established state-of-the-art magnetoencephalography (MEG) laboratory, access to invasive EEG data, SISCOM, FDG-PET, Diffusion Tensor Imaging (DTI) with tractography, a Transcranial Magnetic Stimulation laboratory with real-time navigation capability and simultaneous EEG recording options, and a variety of tools for multimodal image registration.

Comprehensive Neuroscience Center
This new eighteen-bed Pediatric Epilepsy Monitoring Unit is located at Children’s Wisconsin and contains state-of-the-art, video-EEG equipment. The Pediatric Epilepsy Monitoring Unit operates 24 hours a-day, seven days a week and additional has 14 portable vEEG units which allows the EMU to provide remove EEG monitoring services for PICU and ICU patients.  The unit is staffed by a team of dedicated physicians, nurses and EEG technicians specializing in pediatric epilepsy. An on-site EEG lab and advanced techniques such as functional MRI (fMRI) enable noninvasive mapping of language and motor function as well as specialized diagnosis and monitoring. State-of-the-art software and analysis allows co-registration of data from multiple tests, enabling our epileptologists and neurosurgeon to better localize the seizure focus within the brain.

Level 4 Epilepsy Centers

The Adult and Pediatric Epilepsy Centers that constitute the 91ɫƵ Comprehensive Epilepsy Program are both independently designated Level 4 epilepsy centers – the highest rating – by the National Association of Epilepsy Centers. A level 4 epilepsy center serves as a regional or national referral facility and offers:

  • A complete evaluation for epilepsy
  • Advanced neurodiagnostic techniques, including intracranial EEG studies
  • Comprehensive medical, neuropsychological and psychosocial treatment
  • Comprehensive treatments and surgical procedures for epilepsy

ABRET Accreditation 
The Pediatric Epilepsy Center currently holds both ABRET-EEG and ABRET-LTM accreditation. ABRET accreditations are given to EEG labs that comply with established technical standards and demonstrate quality output.

Joint Commission International

The Adult Comprehensive Epilepsy Center at Froedtert Hospital is certified by Joint Commission International as a Center of Excellence for Epilepsy since 2010.

Language Imaging Laboratory

The at the 91ɫƵ, led by Dr. Jeffrey Binder, has pioneered methods for presurgical functional localization of language and episodic memory systems through several NIH funded research programs. The center currently leads a NIH funded multicenter trial evaluating the value of fMRI for mapping language networks in patients undergoing dominant temporal lobe surgery.

Froedtert & 91ɫƵ Magnetoencephalography (MEG) Program

The Froedtert & the 91ɫƵ Magnetoencephalography (MEG) Program, the first and only clinical MEG center in the state of Wisconsin, was established in 2008, and provides a highly sophisticated and rapidly evolving diagnostic tool to help localize epileptic networks as well as identify functional brain tissue prior to brain surgery for epilepsy, tumors, or vascular lesions.