Institute for the Neurosciences Offers New Day Monitoring Services for Epilepsy

The Epilepsy Program, part of the Institute for the Neurosciences, is offering new day monitoring services at Faulkner Hospital, a Brigham and Women’s Hospital community teaching hospital in Boston. Specialists in the Program provide advanced assessment for patients who experience either epileptic seizures or spells with unclear etiology.

Patients are monitored using video electroencephalogram (EEG) equipment for up to eight hours during the day. Synchronizing EEG and video recordings helps specialists decipher a patient’s symptoms, outward presentation, and EEG changes over a period of time. This new service is the only one of its kind in the area to use both video and EEG assessment in a day monitoring capacity.

“This program offers referring physicians and their patients an alternative to inpatient stay for epilepsy monitoring,” said Tracey Milligan, MD, associate neurologist in the Epilepsy Program.

The day monitoring service is housed in a new, state-of-the-art, four-bed unit along with the Neurological Sleep Center, which uniquely performs simultaneous overnight EEG monitoring with polysomnography for the study of patients with undiagnosed nocturnal events or co-existing epilepsy and sleep disorders.

Multidisciplinary Approach to Care
The new day monitoring services are part of a wide range of advanced assessment and treatment options offered at Brigham and Women’s Hospital’s Epilepsy Program. Directed by Edward Bromfield, MD, the multidisciplinary team of experts in the Program includes:

• Neurologists;
• Neurosurgeons;
• Psychiatrists;
• Neuroradiologists;
• Neuro-psychologists;
• Social workers;
• Nurses.

Advanced Treatment for Epilepsy
Treatment options at the Program include medication to control epileptic activity and surgery to treat patients with medically refractory epilepsy. Neurosurgeons in the Program have extensive expertise in performing epilepsy surgery and use sophisticated image guidance and pre-operative planning, including:

• Awake surgery with brain mapping and intraoperative magnetic resonance imaging (MRI) – minimizes the risks of post-operative neurologic dysfunction by individually mapping the cortical surface during surgery to confirm the location for the seizure focus and to identify and preserve critical motor, sensory, and language areas of the brain;
• Intracranial EEG (iEEG) – localizes the source of epileptic activity though the use of surgically-implanted electrodes.

The Epilepsy Program’s new services are part of the Brigham and Women’s/Faulkner Hospitals Department of Neurology. Established last year, the Department expands neurological care to patients who are seen at Faulkner Hospital by offering on-site expert neurological opinions, as well as access to all of the services at the distributed Brigham and Women’s/Faulkner Hospitals campus.

Indications for Referral

• Patients with confirmed epilepsy or spells of unknown origin may be referred for day monitoring services.
• Patients who intermittently experience dizziness, confusion, tingling, vision changes, or lapse in awareness may be referred for monitoring of symptoms.
• Patients with more complex cases may be referred for an overnight stay at the Program’s Neurological Sleep Center.

Access and Information
For more information, or to refer a patient to the Epilepsy Program, please call a Referral Coordinator at (617) 732-9894.