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| Epilepsy |
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Patient Population
The TWH Epilepsy Program is the largest "bench-to-bedside" adult
epilepsy program in Canada. We work in close relationship with the Epilepsy
Program of the Hospital for Sick Children (HSC) and the Bloorview Epilepsy
Program of the University of Toronto. Interactions among these programs
has created the largest academic research-oriented epilepsy program in
the world. The Epilepsy Clinic evaluates more than 1,800 patients annually.
Patients with newly diagnosed epilepsy, as well as those with difficult
to manage seizure disorders are evaluated and followed in the ambulatory
program. The clinic has a special focus on the management of health issues
for women with epilepsy and a transition program has been established
to acquire adult patients from HSC. A two bed Epilepsy Monitoring Unit
(EMU) is the only adult program in Toronto.
Education
Patient education is an important goal of the program. Educational
materials are available for patients, and regular counseling surrounding
medications, women’s health issues and management options is undertaken.
Physicians, research nurses, our ACNP and a volunteer from the Epilepsy
Association of Toronto provide patient education opportunities.
Education of physicians at all levels of training takes place through
the program. The Epilepsy Clinic is a venue for undergraduate ambulatory
experience. Postgraduate trainees in neurology, neurosurgery and other
programs gain experience in the management of patients with epilepsy through
the EMU and ambulatory exposure. Neurosurgical trainees have the opportunity
to learn operative techniques of epilepsy surgery.
Research
Seven basic science labs are examining novel approaches to understanding
and treating epilepsy. Projects include:
- Identification of newly expressed genes in experimental seizure models
- Evaluating the therapeutic basis of the ketogenic diet in patients
with intractable seizures
- Exploring novel ways that brain cells communicate causing synchronization
and seizures
- Studying changes in ion channel distribution in epilepsy
- Studying the effect of blocking "gap junction" communication
between neurons as a strategy for controlling epileptic discharges
- Evaluating the role of ovarian sex steroid hormones in
the modulation and control of seizures
- Mathematical modeling of mechanisms of synchronization
of the neural firing underlying seizure activity
A clinical research program includes:
- Trials of new antiepileptic medications giving the program early access
to the newest pharmacological therapies
- fMRI and spectroscopy for localization of cerebral function in seizure
patients
- Study of the scope and burden of depression in patients with
epilepsy
- Deep brain and vagal stimulation for seizure control in patients
with epilepsy
- Use of the mathematical "chaos" analysis approach for seizure
prediction
- Evaluation of knowledge base for women with epilepsy surrounding
specific health issues
It is hoped that these basic and clinical research approaches
will lead to the development of new treatments for
intractable epilepsy and
strategies which will promote optimal functioning for
people with epilepsy in society.
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