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Epilepsy Center of Excellence (ECoE)

The Epilepsy Center of Excellence (ECoE) at VA Houston specializes in the evaluation of patients with poorly controlled epilepsy, pre-surgical evaluation of epilepsy patients, consultation on treatment of difficult to control epilepsy patients, and the evaluation of patients with paroxysmal non-epileptic events.

Mission

Improve the health and well-being of Veteran patients with epilepsy and other seizure disorders through the integration of clinical care, outreach, research, and education.

Epilepsy is a medical condition that produces seizures that affect a variety of mental and physical functions. When a person has two or more seizures, they are considered to have epilepsy. These seizures are a result of sudden abnormal electrical activity in the brain. The exact type of seizure will depend on where it starts and then spreads within the brain.

Seizures are characterized by a sudden change in movement, behavior, sensation or consciousness produced by an abnormal electrical discharge in the brain. Epilepsy is a condition of spontaneously recurring seizures. Having a single seizure does not necessarily mean a person has epilepsy. High fever, severe head injury, lack of oxygen, or a number of other factors can cause a single seizure.

Epilepsy, on the other hand, tends to be a lifelong condition that affects how electrical energy and connections behave in the brain.
 

Services Offered

The Houston Epilepsy Center of Excellence (ECoE) is the largest center and utilizes state of the art digital diagnostic equipment. Services include electroencephalography (EEG), Video/EEG long-term monitoring (4 bed epilepsy monitoring unit), ambulatory EEG, comprehensive inpatient care, outpatient Epilepsy Clinics, patient education, neuropsychological evaluations, and neuroradiological imaging including MRI, ictal SPECT, and PET scans.

Specialized treatment options including group therapy and individualized cognitive behavior therapy for psychogenic non-epileptic seizures are available on site. Surgical capabilities include access to robot assisted surgery (ROSA), intracranial EEG monitoring, epilepsy surgery, epilepsy device implantation including vagus nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS). 

Inpatient video EEG monitoring enables the physicians to gather additional information about the specific types of seizures patients are having. The more accurately we are able to classify the seizure type, the better the chances are to achieve seizure control.

Additionally, for people who are having spells without a clear diagnosis, video EEG telemetry can often be useful in characterizing such episodes. These spells may be diagnosed as epileptic seizures, but may also be determined to be psychogenic non-epileptic events, syncope, or cardiac-related spells.

Video EEG telemetry also assists physicians in localizing the seizure focus in the brain. This is critical if patients wish to know if they have the type of seizures that may be treated surgically. Seizure surgery is most successful when physicians are able to localize the precise area in the brain where seizures originate. Prolonged video EEG monitoring allows physicians to record a number of seizures, providing the best video and EEG data possible.

The video EEG procedure has two parts:

  1. EEG Telemetry:  As during a routine EEG, electrodes are glued to the  patient’s scalp.  The electrodes then record for 24 hours per day. A computer monitors the EEG recording continuously so that seizure activity can be marked.  This recording gives physicians an accurate count of seizures and allows the doctors to compare what is physically happening to the patient during a seizure with what is seen on the brain wave recordings.
  2. Video:  A camera is used to continuously film the patient while you are connected to EEG electrodes.  By using the video, the physicians can see what happens to patients physically while they are having a seizure.  Seeing what happens physically allows the physicians to better determine what type of seizures the patient is experiencing and where the seizure might be starting in the brain.

ECoE Team

Pitchaiah Mandava, MD, PhD: Neurology Care Line Executive
Zulfi Haneef, MBBS, MD: Center Director
Vitor Pacheco, MD: Staff physician
Kareem Gadelmola, MD: Staff physician
Paul Van Ness, MD: Staff physician
Melissa Fadipe, NP: Nurse Practitioner
Brian Miller, PhD: Neuropsychologist
Sameer Sheth, MD: Neurosurgeon

Contact Info

Location:
     EEG/EMG testing: Room 2B-350, 2nd Floor, main hospital
     Epilepsy Clinic: Room 2B-150, 2nd Floor, main hospital
Phone713-791-1414, ext. 28835
Hours: Monday-Friday, 8:00 a.m.-4:30 p.m. 

Referrals

  • Eligible Veterans within MEDVAMC may be referred to the ECoE  by their personal physician via consult. 
  • Eligible Veterans within VISN 16 may be referred to the ECoE by their personal physician via Interfacility Consult (IFC).

Resources