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Healthcare Professionals
The Epilepsy Center at Hoag Hospital
An estimated 30,000 Orange County residents are living with epilepsy.
The Epilepsy Center at Hoag Hospital serves this population by providing an individualized, comprehensive approach to the diagnosis, treatment, management and research of epilepsy and seizure disorders.
With a personalized program and pioneering technology, the team of specialists at The Epilepsy Center provides the safest and least invasive treatments to help patients achieve the highest level of functionality.
Diagnosis
When patients are referred to The Epilepsy Center, evaluations begin with a thorough exam and medical history, followed by a complete diagnostic workup.
“Utilizing video EEG monitoring, high resolution MRI, MR spectroscopy, functional MR, and positronemission tomography, we focus on accurately identifying the patient’s specific type of seizure and the region of the brain where the seizures originate,” describes Barbara Swartz, MD, PhD, an epileptologist and medical director of The Epilepsy Center.
When in-depth study of a patient’s seizures is required, Hoag’s Epilepsy Monitoring Unit (focused on safety, comfort and rapid diagnosis) is armed with the most recent technology and highly trained staff of physicians, nurses and technicians to evaluate the patient’s seizures over time. During the hospital stay, the patient is under constant visual observation while electrical activity of the brain, other physiological changes and video monitoring of the body’s movements during seizures are recorded. This detailed analysis is used in determining the best treatment options, including potential for surgery.
For those who experience their first seizure as an adult, epilepsy can pose restrictions on work and driving that have major impacts on a person’s lifestyle. Hoag’s new-onset seizure clinic guarantees rapid patient evaluation, including diagnostic testing, usually in one week.
Through a unique collaboration with Children’s Hospital of Orange County (CHOC), Hoag provides a joint adolescent transition program to ease the change from pediatric care to the adult healthcare environment. And as part of this collaborative approach, physician specialists from both Hoag and CHOC meet with other Orange County epileptologists in a weekly case conference. “The case conference brings experts from different disciplines together to plan the best medical treatment for individual patients,” describes Dr. Swartz. “Patients benefit from the combined expertise and experience of the physician collective."
Medical Management
More than 60% of patients can be well controlled and managed with medication. Hoag’s specialists consider each patient’s disease and lifestyle in determining which medications to prescribe.
“And because many antiepileptic medications have side effects and drug interactions,” explains Dr. Swartz, “we work closely with our patients and their primary care physicians to continually and individually manage drug therapy and discuss new drug trials when available.”
Currently Hoag is participating in a number of research studies and investigational trials including evaluations of antiepileptic drugs and the impact on memory, long-term effects of seizures on brain function, and effects of antiepileptic drugs during pregnancy.
“If a patient has failed two antiepileptic drugs, their chances of responding to a third or a combination are only about 5%,” Dr. Swartz asserts. “These patients can benefit from an evaluation at The Epilepsy Center, where we consider further medical therapies and explore surgical options.”
Surgical Interventions
When seizures cannot be controlled with medication, Hoag offers the very latest techniques in surgical intervention for epilepsy.
“Surgery can often reduce or eliminate seizures and even allow some patients to cease antiepileptic medication therapy,” describes Richard Kim, MD, MS, a neurosurgeon and surgical director of The Epilepsy Center.
Hoag’s state-of-the-art neuroradiology enables enhanced imaging of the pathology, and epileptologists and surgeons are skilled in functional brain mapping prior to and during surgery. This, combined with sophisticated neuronavigational equipment and microsurgical techniques, allows neurosurgeons to precisely reach and resect the seizure areas safely.
“Currently, surgery is the only cure for epilepsy, as it eliminates the seizures by removing the segment of the brain causing the condition,” Dr. Kim explains. “Many epilepsy patients can benefit from surgery; therefore, we encourage patients to undergo an evaluation at an epilepsy center like Hoag with fellowship trained epileptologists and neurosurgeons armed with the best diagnostic technology.”
Hoag also offers vagus nerve stimulation (VNS), which can be used as an alternative to the administration of medication therapy alone. The VNS generator delivers low-level intermittent nerve stimulation to the vagus nerve and can effectively block seizures from occurring in a good percentage of individuals.
Both Drs. Swartz and Kim are available for second opinion consultations. To make a referral or for more information on The Epilepsy Center at Hoag Hospital, please call 949/764-8319.
Resources for your patients:
- Epilepsy Support Group: Meets 1st Wednesday of each month
- Hoag Health Center – Aliso Viejo: Treatment office for the convenience of South County residents
- Research studies and clinical trials
- Affiliation with Epilepsy Foundation
- Annual Orange County Epilepsy Symposium for patients and physicians
Check out Hoag Hospital's medical education calendar.
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