Epilepsy Clinic Minneapolis

Epilepsy Clinic St. Paul

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

Magnetic Resonance Imaging (MRI) and  Electroencephalographic (EEG) Findings
in a Cohort of Normal Children With Newly Diagnosed Seizures

Authors
Jason S. Doescher, MD; Ton J. deGrauw, MD, PhD; Beverly S. Musick, MS; David W. Dunn, MD; Andrew
J. Kalnin, MD; John C. Egelhoff DO; Anna Weber Byars, PhD; Vincent P. Mathews, MD; Joan K. Austin,
DNS, RN, FAAN

Abstract
In the initial assessment of children with new-onset seizures, the suggestion that electroencephalography (EEG) should be standard and that magnetic resonance imaging (MRI) should be optional has been questioned. The purposes of this sway were to (1) describe the frequency of EEG and MRI abnormalities and (2) explore relationships between MRI and EEG findings to determine their relevance in the assessment-of children with new-onset seizures who are otherwise developing normally. As part of an ongoing, prospective study of children with new-onset seizures, we studied 181 children (90 girls and 91 boys). Children were entered into the study within 3 months of their first-recognized seizure. The association between EEG and MRI abnormalities was explored using a chi-square test. Abnormal MRI findings were found in 32.6% (n = 59) of the sample. The EEG and MRI results agreed with respect to classification into normal or abnormal in 37% (n = 67). Of the 50 children with a normal EEG, however, 21 (42%) were found to have an abnormal MRI. We found an unexpectedly high frequency of imaging abnormalities in our sample of otherwise normal children, although the significance of these findings is not clear. Follow-up of these patients will help us interpret the importance of the abnormalities. Despite our relatively small sample, however, our findings indicate that a normal EEG does not reliably predict a normal MRI in children with first seizures.

Please follow this link for a complete copy of this abstract.

Epilepsy Doctors Minneapolis

Epilepsy Doctors St. Paul

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

 

The Benefits of a Pediatric Individual Seizure Emergency Plan – Parent and Caregiver Perception

This paper has been prepared specifically for the American Epilepsy Society Annual Meeting in Boston, MA, December 5 – 10, 2003.  Please consider this information to be preliminary findings.

Authors
Vickie Karney, RN, BSN
Carol Hoskin, RN
Michael D. Frost, MD
Frank J. Ritter, MD

Rationale
For people unfamiliar with epilepsy, a generalized tonic-clonic seizure is a frightening experience, while more subtle seizures may go unrecognized. We have designed a simple, one page, Individualized Seizure Emergency Plan (ISEP) for children with seizures. The purpose of the ISEP is to help parents and caregivers, (school, daycare, group home, etc.) to understand what to expect and what to do in the event of a seizure. Our hypothesis is: Having a simple, written, child specific plan (ISEP), should prevent delay in appropriate action, decrease emergency department (ED) visits and calls, and decrease anxiety in caring for a child with seizures.

Please follow this link for a complete copy of this abstract.

If you would like to make an appointment with one of our adult or pediatric neurologists, please give us a call at (651) 241-5290.

Pediatric Epilepsy Positions

Adult Epilepsy Positions

Minnesota Epilepsy Group, PA® in St. Paul, Minnesota, is seeking adult and pediatric BC/BE neurology specialists to join three pediatric and three adult 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, 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 pediatric LTM unit and 10 bed adult 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 outstanding educational system, cultural diversity, activities for the outdoor enthusiast and ample dining and entertainment.

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

Epilepsy Positions

Adult and Pediatric Epileptologist Positions

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.  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 pediatric LTM unit and 10 bed adult 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 outstanding educational system, cultural diversity, activities for the outdoor enthusiast and ample dining and entertainment. 

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

Epilepsy Care Minneapolis

Epilepsy Care St. Paul

Minnesota Epilepsy Group is the 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.

Lyrica®

Lyrica® (LEER-a-ka) is approved as add-on therapy in the treatment of partial onset seizures in adults. Lyrica is available in capsules in eight dosage strengths from 25mg to 300mg.

Lyrica® is given by mouth and it is given two or three times per day with or without food.

The most common side effects of Lyrica include dizziness, blurred vision, weight gain, sleepiness, difficulty concentrating, swelling of hands and feet, and dry mouth.

Safety in pregnancy has not been established. It is known that women taking antiepileptic drugs have higher incidence of birth defects than women who are not. Lyrica® should be used during pregnancy only if the potential benefit justifies the potential risk to the unborn child. Women who are taking this medication and who wish to become pregnant should discuss treatment options with their physicians before the pregnancy begins. It is not known whether this drug is passed in breast milk, but is common with most anticonvulsants.

Lyrica® is eliminated through the kidneys and is therefore unlikely to be affected by other medications. No interactions have been observed between Lyrica® and carbamazepine, valproic acid, lamotrigine, phenytoin, phenobarbital, and topiramate.

Patients should take the medicine as prescribed by your physician. Stopping this medication suddenly can produce unwanted side effects and potentially increase seizure frequency.

A history of an allergic reaction to pregabalin or any of its components. 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 are the drugs prescribing information sheet (package insert), the Physicians Desk Reference, or pharmaceutical company that produces the drug.

Link to Product Information on Lyrica: http://www.lyrica.com/content/epi_home.jsp

Please give us a call to schedule an appointment at (651) 241-5290.

Epilepsy Care St. Paul

Epilepsy Care Minneapolis

Minnesota Epilepsy Group is the 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.

Keppra

Keppra (KEPP-ra) was approved by the Food and Drug Administration in 1999 as an add-on therapy for partial seizures in adults.  Keppra is available as tablets and an oral solution.

The side effects of taking Keppra include sleepiness, unsteadiness, infection, behavior disturbance and dizziness.  Side effects are most likely during the first four weeks of treatment. Keppra has not been reported to interact with other antiepileptic drugs, warfarin, or oral contraceptives. There are case reports of carbamazepine toxicity reported when Keppra was added, but this was not due to a direct drug interaction.

It reaches a steady state (that is, an effective treatment level in the blood) approximately two days after it is begun. Keppra is eliminated through the kidneys and dosage adjustments may be needed in patients with kidney disease or on dialysis. The drug should not be discontinued abruptly due to the risk of increased seizures, unless warranted by severe side effects.

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 more information about this medication, please follow the link to product information at http://www.ucb-group.com/products/866.htm

You may contact Minnesota Epilepsy Group by calling (651) 241-5290.

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.