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May 2007 Issue

Epileptologists Michael Privitera, MD, (left) and David Ficker, MD, discuss a patient's condition.
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Specialized Epilepsy Centers Key to Better Seizure Control

Published May 2007

For people with epilepsy, controlling seizures can mean the difference between working or unemployment, or driving yourself or taking the bus.

Researchers at UC say the key to managing these episodes—which can be as subtle as a brief staring spell, or as traumatic and life-threatening as a series of convulsions—may be where you seek treatment.

An abstract presented May 1 at the American Academy of Neurology meeting by UC epileptologist David Ficker, MD, and neurology resident Tarek Zakaria, MD, shows that 69.1 percent of epilepsy patients managed at Cincinnati Epilepsy Center—a specialized epilepsy treatment center—remained seizure free for one year.

Prior to treatment at the center, only 48.2 percent of patients experienced one year without seizures.

Seizure frequency also decreased from 4.9 seizures per month to 2.2 following treatment by an epileptologist.

Of 56 patients originally treated at the center—averaging 39.2 years old and 14.4 years since diagnosis with epilepsy—53 were evaluated in a follow-up visit.

“Seizures can really affect quality of life,” said Ficker, associate professor of neurology at UC and a member of the Neuroscience Institute at UC and University Hospital. “Successfully controlling seizures can improve relationships and may allow people the opportunity to gain employment and driving privileges that they might not have had before.”

In 2001, following managed-care changes at a large private-practice neurology group in Cincinnati, more than 50 epilepsy patients turned to the Cincinnati Epilepsy Center for treatment.

Ficker, medical director of the center’s EEG Lab and Epilepsy Monitoring Unit, saw this influx of patients as an ideal opportunity for gathering key outcomes data that hadn’t existed before.

“We have little data comparing seizure-control success of patients treated at specialized epilepsy centers versus general neurology practices,” said Ficker. “And because this particular patient group wasn’t specifically referred to us for treatment, we saw it as a great opportunity to evaluate outcomes and continue improvement.”

The benefits of treatment at an epilepsy center—beyond being seen by epilepsy specialists—says Ficker, include more opportunities to be involved in neuroimaging research and the testing of novel medications for seizure control.

Epilepsy is a neurological disorder that causes dysfunction in the electrical system within the brain—leading to seizures. Seizures take on many forms, from brief moments of unconsciousness to convulsions. Epilepsy can be treated with medication, but if medication alone does not control seizures, other treatment options are available, including surgery and vagus nerve stimulation. Epilepsy surgery is only available at specialized epilepsy centers.

According to the Epilepsy Foundation, more than 3 million Americans are living with epilepsy and each year, 200,000 will develop the disorder. Epilepsy affects people of all ages, races and ethnicities.

Coauthors for the study include Jennifer Cavitt, MD, Michael Privitera, MD, and Jerzy Szaflarski, MD, PhD.

The Cincinnati Epilepsy Center celebrates its 20th anniversary in 2007. Rated a level 4—the highest rating for epilepsy care—by the National Association of Epilepsy Centers, the center provides evaluation and coordinated medical and surgical treatment of epilepsy.

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