Clinical Divisions >
EPILEPSY

The Vanderbilt Epilepsy Division specializes in the diagnosis and treatment of epilepsy and seizures. Epilepsy is a neurological condition characterized by recurrent unprovoked seizures. Seizures are caused by a sudden abnormal electrical discharge in the brain, which can produce a variety of symptoms and signs, including loss of consciousness and involuntary movements. This condition affects approximately one percent of Americans at any given time. Approximately three percent will develop epilepsy by age 75. Approximately one third of patients with epilepsy are resistant to medical treatment. Persistent seizures can deteriorate quality of life for sufferers. This is why the Vanderbilt Epilepsy Division aims to completely eliminate seizures. Vanderbilt neurologists specialize in diagnosing epilepsy, and creating treatment plans to eliminate the occurrence of seizures.

Faculty/ Staff
Robert Macdonald, M.D., Ph.D.
Bassel Abou-Khalil, M.D.
Amir Arain, M.D.
Nabil Azar, M.D.
Christine Dong, M.D.
Martin J. Gallagher, M.D., Ph.D.
Kevin Haas, M.D., Ph.D.
Andre Lagrange, M.D., Ph.D.
Michael J. McLean, M.D., Ph.D.
Gregory C. Mathews, M.D.
Pradumna Singh, M.D.
Barbara Page, Secretary
Patsy Ramey, R.N., Clinical Epilepsy Nurse

Clinical Research Staff
Melissa Osborn, R.N., Research Coordinator
D. Barrett Share, M.A. , Research Coordinator
Amanda Crawford, R.N., Research Coordinator
Kelly Lowen, Research Support

Pediatric Epilepsy
Gregory Barnes, M.D., Ph.D.
Kevin Ess, M.D.
Juliann Paolicchi, M.D.
Eric Piña-Garza, M.D.

The Clinical Epilepsy Division of the Department of Neurology includes an outpatient clinic, the EEG laboratory, and the inpatient epilepsy-monitoring unit.

Epilepsy Clinic
The Epilepsy clinic focuses on evaluation and treatment of patients with drug-resistant epilepsy, unusual seizures, and spells of unknown nature. Patients receive extensive interviews and examination, are referred for appropriate testing, receive treatment with antiepileptic drugs, or are referred for epilepsy surgery evaluation, or vagus nerve stimulation.

EEG Laboratory
The EEG Laboratory performs electroencephalographic (EEG) recordings on outpatients and inpatients with seizures, spells, as well as a variety of other conditions. The EEG, which records brain electrical activity, can provide evidence for epilepsy by demonstrating signs of electrical irritability.

Epilepsy Monitoring Unit
The eight-bed Vanderbilt Adult Epilepsy Monitoring Unit is the largest in Tennessee. The Monitoring Unit allows patients to receive EEG-video monitoring, usually in conjunction with some medication withdrawal. Vanderbilt neurologists record typical attacks to characterize, classify and localize them to determine the best treatment options. Recordings are taken either from the scalp, or from surgically implanted electrodes should localization be difficult. There is also a four-bed Pediatric Epilepsy Monitoring Unit in the Children’s hospital.

Pre-Surgical Evaluation
Some patients who do not respond to seizure medications may benefit from epilepsy surgery. In some forms of epilepsy, surgical treatment provides seizure freedom to 60-80% of operated patients. Neurologists perform comprehensive pre-surgical evaluations which usually include a detailed history and physical examination, EEG-video monitoring, special MRI scan, PET scan, neuropsychological testing, and Wada test, and may also include ictal SPECT scan, magneto-encephalography (MEG), and functional MRI (fMRI) scans. In some instances electrode grids are implanted over the brain. Electrical stimulation of these electrodes helps localize functions in the brain that need to be preserved during surgery.

Vagus Nerve Stimulation
Vagus Nerve Stimulation (VNS) is a treatment device that generates electrical impulses delivered to the vagus nerve in the neck. These impulses then indirectly affect the brain. The generator is a small, flat round battery that is surgically implanted under the skin over the chest or in the armpit. Vanderbilt offers this procedure, which is FDA approved for use in adults and children over the age of 12 who have partial seizures that are resistant to medications. Since this procedure rarely stops seizures completely, it is offered mainly when surgery does not seem an option.

Education
The Epilepsy Division offers training to clinical neurophysiology fellows as well as neurology residents, who rotate through the epilepsy clinic, EEG laboratory, and Epilepsy Monitoring Unit.
There are various education programs offered by the Division, including a year-long clinical neurophysiology course, twice monthly epilepsy topics conference, monthly epilepsy surgery conferences, monthly journal review conference, and monthly EEG teaching conference.

Research
The Epilepsy Division is involved in both basic and clinical epilepsy research. Current clinical research involves investigational epilepsy drug trials, clinical genetics, fMRI imaging, as well as epilepsy surgery. The division was one of 20 centers in the U.S. participating in an NIH sponsored, multi-centered controlled trial of early surgery, Early Randomized Surgical Epilepsy Trial– ERSET – to explore how early to offer surgery to those suffering from mesial temporal lobe epilepsy.

Clinical Trials in Seizures / Epilepsy
The division is evaluating several experimental drugs for use in refractory epilepsy.

For questions regarding clinical protocols call:
Melissa Osborn, R.N. - Study Coordinator at 615-322-8817
To learn more about clinical research studies, click here.

Referral and Patient Information
To contact the Epilepsy Division for patient referrals call (615)-936-0060.

For more information on the Neurodiagnostics Lab, click here.