New state-of-the-art wireless brainwave recording technology at Albany Medical Center that uses advanced computer systems and seizure recording equipment is enabling doctors to pinpoint the area of the brain where seizures begin.
According to Dr. Anthony Rittaccio, professor of neurology and neurosurgery, the wireless technology will enable patients to move around the six-bed units more freely, without needing to be confined to bed.
“We bring folks here and reduce or eliminate their seizure medication,” explained Ritaccio. “And we invite them to have seizures under incredibly controlled circumstances, because that can tell us whether we need to get the patient off a particular medication because another one is better.”
Approximately three out of four patients do well on medication, said Ritaccio.
When drugs fail to control or substantially reduce seizures, surgery on the brain may be considered. Most surgical patients are adults who have fought long and unsuccessful battles for seizure control.
However, both children and adults with severe seizures are candidates for surgery, provided the electrical problem is in a part of the brain that can be resolved without damaging important things like speech, memory or eyesight.
Rittaccio said approximately one in four patients are eligible for surgical treatment of their epilepsy after undergoing a brain-mapping procedure as a diagnostic tool to identify specific areas of the brain that are short-circuiting or causing the seizures.
“If we can see the seizures are electrically coming from a region where it makes sense for us to surgically remove it, we can surgically cure them, which means no more medications,” said Ritaccio.
Before the wireless technology became available, Ritaccio said patients were required to be confined to their beds for several days.
“They would be wired up, and then literally be plugged into a device on a wall that would communicate with our computers,” said Ritaccio.
“Our patients now have a unit in their room, and they are wireless and able to ambulate freely. Then we have access to the data anywhere. So if I’m giving a lecture in Italy next week, I can go online and get patient results.”
Ritaccio said being stuck in a bed for five days was extremely difficult, especially for children.
“If you’re two years old, and you can play on the floor, you’re more apt to allow us to help you,” said Ritaccio. “Adults can sit in our lounge area and have guests while they are still being monitored for seizures.”
Each of the private rooms also has cameras so nurses and technologists can continually monitor patients. Rooms are also equipped with rubber floors in case a patient has a seizure and falls.
Each year, Albany Med performs more than 2,000 electroencephalograms and evaluates over 300 patients in its inpatient epilepsy monitoring unit for improved medical care or surgical care. The unit operates 24 hours a day, seven days a week.
Most people spend an average of five days.
“If you are a good candidate for medicine because there is a syndrome where a drug fits in, we give drugs,” said Ritaccio. “If you have tried six or seven medicines, and you’ve had this problem for 20 or 30 years, and the recording of your seizures shows that they come from a place that is surgically accessible and won’t result in any deficits, then we try to cure you surgically.”
Free to move about
Jara Lane, 17, of Kingston, has had a genetic form of epilepsy for about a year.
“It came on suddenly,” said Lane, a senior at Kingston High School.
“I’m really glad I wasn’t stuck in my hospital bed,” said Lane, “It was nice to be able to stretch my legs and walk out in the hallway.”
Lane had several brief seizures in the hospital in which she stared off into space for a few seconds, which were recorded on the monitoring equipment.
She did not have any full-blown convulsions in which she lost consciousness for a minute or two. But she has had several at home and at school.
“I’m scared to do very much,” said Lane. “I can’t drive. I can’t hold a job. It’s kind of hard. I’m scared to go anywhere with my friends and stuff. I’m hoping the new medication will keep me stable, and I won’t have a lot of seizures.”
Jeannine Mayr, Lane’s mother, said she is also scared to let her daughter do anything.
“My mind is on her 24 hours a day,” said Mayr. “We’re hopeful the new medication will help.”
Epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions. When a person has two or more seizures, they are considered to have epilepsy.
If only part of the brain is affected, it may cloud awareness, block normal communication and produce a variety of undirected, uncontrolled, unorganized movements.
Most seizures last only a minute or two, although confusion afterward may last longer.
More than three million people in the United States have some form of epilepsy. About 200,000 new cases of seizure disorders and epilepsy are diagnosed each year.
Medicines are the most common type of epilepsy treatment.
First aid for seizures is simple. Keep calm and make sure the person having the seizure is comfortable and safe from harm.
Ritaccio said although full-blown seizures last only a minute or two, people are exhausted for several hours afterwards.
“Many people can’t make a decent memory for days,” he said. “That can make it very hard for kids in school. This is a chronic disease that never stops. That doesn’t mean you can’t be seizure-free, but you still have the responsibility to check in with your doctor on a regular basis.”