Epilepsy Minneapolis

Minnesota Epilepsy Group is the largest and most comprehensive epilepsy program in the Midwest.  As a level IV epilepsy center – the highest level established through the National Association of Epilepsy Centers – we offer a complete range of inpatient and outpatient services for both adults and children.

The following information is designed to help people with epilepsy become more familiar with available seizure medications.

Gabitril®
Generic Name: Tiagabine HDl
 
GABITRIL® (tiabagine HDl) is indicated as adjunctive therapy in adults and children 12 years and older in the treatment of partial seizures.

Uses:
Treatment of partial seizures as add-on therapy in adults and children 12 years and older.

How it works:
Gabitril® works by helping one of the brain chemicals (GABA) to work better. It is well absorbed when taken by mouth and is best taken with food to avoid sharp rises in blood levels. It is broken down primarily by the liver. The half life is 7 to 9 hours in adults.

Forms of the medicine:
Gabitril® tablets are available in four dosage strengths; 2, 4, 12 and 16 milligrams

Dosing: Gabitril® is given by mouth. It is given twice or four times per day with food. Dosing amounts and frequency of dosing will be decided by the treating physician. Dosing will usually start with about 4 milligrams per day and will likely be increased over time.

Side Effects:
The most common side effects include sedation, fatigue or muscle weakness, nervousness, headache, fatigue, irritability, difficulty with concentration, tremor, and dizziness.

Information for Pregnant women and nursing mothers: Safety in pregnancy has not been established. It is known that women taking antiepileptic drugs have a higher incidence of birth defects than women who are not. Women who are taking this medication and who wish to become pregnant should discuss treatment options with their physicians before the pregnancy begins. Gabitril® is passed into breast milk.

For a complete overview of Gabitril®, please follow the link provided.

Epilepsy Minneapolis

Minneapolis Epilepsy

Minnesota Epilepsy Group, the most comprehensive epilepsy center in the Midwest, frequently relies on antiepileptic medications in treating its pediatric and adult epilepsy patients.

The following information is designed to help people with epilepsy become more familiar with available seizure medications.

Dilantin® Infatabs®
Generic Name: Phenytoin Tablets

Dilantin (Di-LAN-tin) was developed in 1938 as the first modern antiepileptic drug and has been used ever since as first line therapy for partial and generalized tonic clonic seizures. It is not effective against myoclonic, atonic (drop attacks) and absence seizures. Dilantin is generally given as capsules or chewable tablets, usually once or twice a day. A related product (Cerebyx – fosphenytoin) is available for intramuscular and intravenous use against status epilepticus (non-stop seizures), replacing the previous formulation.

Dilantin is metabolized (processed) in the liver. It interacts with a number of other antiepileptic drugs and other drugs, including oral contraceptives, Coumadin, quinidine, vitamin D and folic acid. At high doses, a small additional dose or slightly lower dose produces disproportionately large changes in blood levels, with consequent seizures (when levels drop) or increased side effects (when levels rise abruptly). At high levels, short term side effects such as difficulty in concentration, slow motor speed, unsteadiness, double vision, nausea and drowsiness may occur. Seizures may also increase. Longer term side effects include gum overgrowth (gingival hyperplasia), excessive hairiness (hirsutism), thickening of facial features, nystagmus, rash and folate deficiency. Rare reactions include serious rash, bone marrow suppression and effects on the lymph system and a lupus like syndrome. Safety in pregnancy has not been established. Women who are taking this medication and who wish to become pregnant should discuss treatment options with their physicians before the pregnancy begins.

Not everyone experiences side effects. There may be other side effects not appearing above. For a complete list, consult your doctor, nurse, or pharmacist. More detailed sources of information on side effects include the drug’s prescribing information sheet, the Physician’s Desk Reference, or pharmaceutical company which produces the drug.

To find a complete description of this medication, please follow the link provided.  If you would like to schedule an appointment with one of our physicians, please give us a call at (651) 241-5290.

Epilepsy Minneapolis

Minneapolis Epilepsy

Minnesota Epilepsy Group’s approach to patient care involves a team of experts, from a variety of medical specialties, working together to find the most effective treatment for each patient.

The most common treatment options for people with epilepsy are medications, surgery and vagus nerve stimulation.  The ketogenic diet is also utilized with children and some adults.

Since medications are a common source of treatment for epilepsy, it is important to be aware of the options available.  The following provides an overview of the epilepsy medication, Dilantin. The information is designed to help people with epilepsy become more familiar with seizure medications.  It is not for use by health or other professionals to identify drugs, nor is it an exhaustive list

Dilantin 
Generic Name: Phenytoin Suspension
 
Dilantin (Di-LAN-tin) was developed in 1938 as the first modern antiepileptic drug and has been used ever since as first line therapy for partial and generalized tonic clonic seizures. It is not effective against myoclonic, atonic (drop attacks) and absence seizures. Dilantin is generally given as capsules or chewable tablets, usually once or twice a day. A related product (Cerebyx – fosphenytoin) is available for intramuscular and intravenous use against status epilepticus (non-stop seizures), replacing the previous formulation.

Dilantin is metabolized (processed) in the liver. It interacts with a number of other antiepileptic drugs and other drugs, including oral contraceptives, Coumadin, quinidine, vitamin D and folic acid. At high doses, a small additional dose or slightly lower dose produces disproportionately large changes in blood levels, with consequent seizures (when levels drop) or increased side effects (when levels rise abruptly). At high levels, short term side effects such as difficulty in concentration, slow motor speed, unsteadiness, double vision, nausea and drowsiness may occur. Seizures may also increase. Longer term side effects include gum overgrowth (gingival hyperplasia), excessive hairiness (hirsutism), thickening of facial features, nystagmus, rash and folate deficiency. Rare reactions include serious rash, bone marrow suppression and effects on the lymph system and a lupus like syndrome. Safety in pregnancy has not been established. Women who are taking this medication and who wish to become pregnant should discuss treatment options with their physicians before the pregnancy begins.

Not everyone experiences side effects. There may be other side effects not appearing above. For a complete list, consult your doctor, nurse, or pharmacist. More detailed sources of information on side effects include the drug’s prescribing information sheet, the Physician’s Desk Reference, or pharmaceutical company which produces the drug.

To find a complete description of this medication, please follow the link provided.

Epilepsy and H1N1

Immunizations & Epilepsy

Dear patients & families,

As we continue to follow recent statements from the CDC concerning the H1N1 virus and seasonal flu, we feel that the benefits of receiving the current vaccinations outweigh the potential risks. The CDC currently recommends immunizations for individuals aged 6 months to 24 years as well as those who live with or care for infants younger than 6 months. Pregnant women are also encouraged to receive flu immunizations. The CDC has recognized that children with neuro-developmental or respiratory disorders are at higher risk for complications associated with a flu infection. We are recommending our patients receive these important immunizations.

Some families have expressed concern regarding immunizations. On rare occasions, inflammatory responses following vaccines may provoke seizures, similar to fever or infection. Careful observation as well as preparation with rescue medications (Diastat/diazepam) and emergency plans can minimize complications. Seizures or progressive weakness should be reported to the clinic. Fevers may be treated with short courses of ibuprofen and should be reported to your pediatrician’s office. Hand washing and other preventative measures should be consistently practiced throughout the flu season.

Certainly the utilization of vaccinations is a family decision and should also be guided by your pediatrician. We recommend discussing the availability and scheduling of immunizations with your pediatrician’s office.

The CDC also recommends children with neuro-developmental disorders including those with epilepsy, receive prompt antiviral therapy following recognition of influenza infections. This should also be directed and discussed with your pediatrician.

Epilepsy Care Twin Cities

Infant Functional Hemispherectomy: Technical Considerations, Safety, Results

Minnesota Epilepsy Group, the most comprehensive epilepsy center in Minnesota, routinely participates in research that advances the quality of care delivered to pediatric and adult epilepsy patients.

This summary abstract has been prepared specifically for the American Epilepsy Society Annual Meeting,  Boston, MA, December 5 – 10, 2003.  Follow this link for a complete copy of the abstract.

Authors
Mary E. Dunn, MD, FACS
Michael D. Frost, MD
Frank J. Ritter, MD

Introduction
Pediatric epilepsy surgeons and epileptologists have been hesitant to perform hemispherectomies in small infants due to issues of blood volumes and potential complications.

Question: Can hemispherectomy be performed safely, effectively in infants?

Study Population
There were 408 pediatric intracranial epilepsy procedures performed with the Minnesota Epilepsy Surgery Group at Children’s Hospital of St. Paul, Minnesota between 07/01/1991 and 04/01/2003. There were 21 functional hemispherectomies in this group. Of these, four were infants less than 5 months of age.

Clinical Features
1. Clinical epileptic events noted within 24 hours of birth.
2. EEG: Unilateral hemispheric epileptiform discharge greater than 100 events per day in each infant. Unilateral hemispheric interictal abnormality in each infant.
3. Imaging MRI: Hemimeganencephaly (1), hemispheric migrational abnormality, dysplasia (3) (Fig. 1) PET: Hypometabolism anomaly (2)
4. Medical Therapies initiated with failure: 3+ seizures med (4) ACTII (2) Dietary modifications (2)
5. Preoperative average weight was 5.76 kg.
6. Average preoperative hemoglobin was 10.5

Technique of Functional Hemispherectomy
1. Large C shaped incision
2. Temporal lobectomy
3. Excision of central region
4. Insular cortex removal
5. Disconnection of parietal-occipital lobes
6. Disconnection of frontal lobe
* 7. Subcallosal gyrus resection – gene and splenium
* 8. Pre M, cortical resection (Fig 2)

Procedure duration average was 6.5 hours (3). The first infant with hemimegalencephaly required a two-stage procedure. Intraoperative transfusion occurred in one infant. Postoperative transfusion at 24 hours in one infant with postoperative hemoglobin of 5.3 and no transfusion in two infants with hemoglobin greater than 5.6. These infants were given iron supplementation.

* Failure to accomplish #7 and #8 resulted in reoperation on the infant with
hemimegalencephaly

Results
• Average follow-up was 5 years, 8 months.
• All patients are off seizure meds and seizure free at last visit
• One patient (hemimeganencephaly) required reoperation with pre M, and subcallosal cortex resection at 2.5 years of age. He had been seizure free for one year with presumed recurrence in insular cortex. He is now seizure free and off meds for 5 years.

Conclusion
Infants can safely undergo indicated functional hemispherectomy with minimal morbidity and excellent seizure outcome.

Epilepsy Conference – Living with Seizures – Today and Tomorrow

Epilepsy Care Twin Cities

In addition to providing comprehensive epilepsy care, the physicians of Minnesota Epilepsy Group routinely educate the community on issues related to the treatment of epilepsy.

The upcoming conference, Living with Seizures – Today and Tomorrow, is intended for people with epilepsy, family and loved ones of those living with seizures, medical and care professionals, and school personnel.

Dr. Patricia Penovich of Minnesota Epilepsy Group will be speaking on “Life Matters: Sex, Relationships & Family”.  Please follow the link provided to obtain more information about this conference.

Patricia E. Penovich, MD
Dr. Penovich received her Bachelor’s degree in chemistry from the College of Wooster, Wooster, Ohio.  At Case Western Reserve University she did graduate work in pharmacology and received her M.D. degree.  At the University of Rochester, Dr. Penovich completed her neurology residency and a fellowship in clinical pharmacology.  She completed additional training in EEG and epilepsy at the University of Rochester and the University of Minnesota.  Dr. Penovich is board certified by the American Board of Psychiatry and Neurology in Neurology and Clinical Psychiatry and is certified by the American Board of Clinical Neurophysiology in Clinical Neurophysiology.  She is an examiner for The American Board of Psychiatry and Neurology. Dr. Penovich is currently an Adjunct Professor of Neurology at the University of Minnesota and is also the Director of Neurology and Epilepsy at Minnesota Epilepsy Group/United Hospital.  She has published in the areas of clinical neurology, neuropharmacology and epilepsy.  She is involved in research of investigational medications for the treatment of epilepsy.  Dr. Penovich is a past Board Member and was the Chair of the Conference Committee from 2003-07. She is currently a member of the Professional Advisory Board of the Epilepsy Foundation of Minnesota.

Neuropsychology Testing Twin Cities

Neuropsychology Testing Minneapolis

The psychologists and neuropsychologists of Minnesota Epilepsy Group play an important role in assessing cognitive risks in patients being considered for epilepsy surgery and in providing supportive counseling to the patients and their families during the surgical decision making process.

Our experienced pediatric and adult psychologists and neuropsychologists offer a full range of services including clinical evaluation and treatment, comprehensive neuropsychological assessment, special procedures to identify language and memory in each hemisphere of the brain as well as mapping of other cognitive functions.

To obtain more information about testing or neuropsychological evaluations, please visit us our website or please give us a call at (651) 241-5290.

Top Epilepsy Programs

Top Epilepsy Centers

Minnesota Epilepsy Group is designated as a Level IV Epilepsy Center – the highest rating by the National Association of Epilepsy Centers.

As a Level IV epilepsy center, Minnesota Epilepsy Group offers the most comprehensive range of diagnostic and treatment options available.  Services offered through our nationally recognized program include:

• Inpatient Epilepsy
• Magnetoencephalograpy (MEG)
• Intracranial Monitoring
• Outpatient Evaluations for Epilepsy
• Epilepsy Surgery
• Neuropsychology and Psychology
• Research
• Intraoperative Monitoring

Please visit our website at mnepilepsy.org or call us to schedule an appointment.  We may be reached at (651) 241-5290.

Pediatric Epileptologist Position

Adult Epileptologist Position

Minnesota Epilepsy Group, PA® in St. Paul, Minnesota, is seeking adult and pediatric BC/BE neurology specialists to join three adult and three pediatric epileptologists in an academic private practice dedicated to epilepsy care.  Fellowship training is required; BE/BC in clinical neurophysiology is desired.  Scope of practice includes long term video EEG monitoring, inpatient and outpatient clinical care, intraoperative monitoring, magnetic source imaging (magnetoencephalography) in our MSI Center, and research, including pharmaceutical trials.

We are affiliated with United Hospital and Children’s Hospitals and Clinics of Minnesota-St. Paul, with a 10 bed adult LTM unit and 10 bed pediatric unit.  Clinical university appointment is available through the University of Minnesota.  Competitive salary and benefits are commensurate with prior training and experience.  EO/AA.

The Twin Cities of Minneapolis-St. Paul offers an excellent educational system, cultural diversity, activities for the outdoor enthusiast and ample dining and entertainment.  The vitality and quality of life in Minnesota is surpassed by none.
 
Interested applicants should send their CV and three references to:

Mike Frost, MD, President
c/o Paul Louiselle, Executive Director
Minnesota Epilepsy Group, PA®
225 Smith Avenue North, Suite 201
St. Paul, MN, 55102 USA
Phone: 651.241.5290
Fax: 651-241-5140

or e-mail your information to plouiselle@mnepilepsy.net

Pediatric and Adult Epileptologist

Adult and Pediatric Epileptologist

Minnesota Epilepsy Group, PA® in St. Paul, Minnesota, is seeking pediatric and adult BC/BE neurology specialists to join three adult and three pediatric epileptologists in an academic private practice dedicated to epilepsy care.  We are affiliated with United Hospital and Children’s Hospitals and Clinics of Minnesota-St. Paul, with a 10 bed adult LTM unit and 10 bed pediatric unit. Fellowship training is required; BE/BC in clinical neurophysiology is desired.  Scope of practice includes long term video EEG monitoring, inpatient and outpatient clinical care, intraoperative monitoring, magnetic source imaging (magnetoencephalography) in our MSI Center, and research, including pharmaceutical trials.  Clinical university appointment is available through the University of Minnesota.  Competitive salary and benefits are commensurate with prior training and experience.  EO/AA.

The Twin Cities of Minneapolis-St. Paul offers an excellent educational system, cultural diversity, activities for the outdoor enthusiast and ample dining and entertainment.  The vitality and quality of life in Minnesota is surpassed by none.
 
Interested applicants should send their CV and three references to:

Mike Frost, MD, Vice President
c/o Paul Louiselle, Executive Director
Minnesota Epilepsy Group, PA®
225 Smith Avenue North, Suite 201
St. Paul, MN, 55102 USA
Phone: 651.241.5290
Fax: 651-241-5140

or e-mail your information to plouiselle@mnepilepsy.net