The Epilepsy Surgery Program at UAMS
At UAMS, we are proud to host the only comprehensive Epilepsy Surgery Program for adults in the State of Arkansas. Patients undergoing referral to our center are reviewed systematically by a specialized multi-disciplinary team led by Dr. Viktoras Palys and comprised of a team of epilepsy-trained neurologists, a dedicated epilepsy nurse-practioner, neuroradiologists, neuropsychologists and neuropathologists. Moreover, we are now in close collaboration with our pediatric colleagues at the Arkansas Children’s Hospital and meet regularly to review challenging adult and pediatric epilepsy cases for surgical consideration.
Invasive EEG Monitoring at UAMS
The Epilepsy Surgery Program at UAMS benefits from the latest advances in technological innovation and cutting-edge techniques for the accurate investigation and surgical treatment of medically refractory epilepsy. Our invasive EEG monitoring procedures include stereoelectroencephalography (SEEG), referring to the safe and minimally-invasive surgical implantation of customized electrodes into the depths of the brain for seizure monitoring. This procedure has been used in Europe for over 50 years, but has only recently emerged in a small handful of North American centers. At UAMS, this procedure is now bolstered by an advanced stereotactic robotic system (conventionally called ‘ROSA’) that aids us in performing SEEG with excellent clinical results. We also often use conventional grid electrodes to record electrical seizure activity directly from the surface of the brain. Either of these techniques may be used to identify a potential seizure focus over the course of a short in-hospital admission, and they allow for additional clinical testing to ensure that resection may be safely achieved.
Epilepsy Surgery at UAMS
Once a seizure focus is safely identified, patients are scheduled for surgical resection of this region of the brain, in the hopes of achieving seizure-freedom. Our Epilepsy Surgery Program at UAMS is fortunate to offer the entire spectrum of surgical procedures for treating properly screened candidates with medically refractory epilepsy. Most procedures involve surgically removing or disconnecting an epileptic focus or region in the brain, as in lesionectomies, temporal resections and extra-temporal resections. Occasionally, a larger hemispherectomy procedure may be indicated, a procedure selectively reserved for challenging and very severe types of epilepsy. Other palliative procedures when surgical removal/disconnection is not an option involve the implantation of a neurostimulator device, such as the vagal nerve stimulator (VNS) or a responsive neurostimulator (Neuropace). For all surgical patients, a formal pre-operative consultation is held with an epilepsy-trained neurosurgeon to discuss the various options available and to decide on a tailored, customized surgical plan.