Spectrum Health Expands Epilepsy Monitoring Unit

Reflects Increased Capabilities of Growing Epilepsy Team

Spectrum Health is expanding its inpatient epilepsy monitoring unit (EMU) as it increases the size and expertise of its epilepsy team. The newly renovated and expanded eight-bed unit, located at Butterworth Hospital, is considered one of the largest in the state. Helen DeVos Children’s Hospital also maintains a six-bed EMU for pediatric patients.

According to the Centers for Disease Control and Prevention (CDC), epilepsy affects 2.2 million Americans. Spectrum Health is the first epilepsy program in West Michigan to receive a Level 4 designation by the National Association of Epilepsy Centers (NAEC). Level 4 centers have the professional expertise and facilities to provide the highest level of medical and surgical epilepsy evaluation and treatment for patients with epilepsy.

Spectrum Health’s original epilepsy monitoring unit opened with four beds in 2011 under the direction of Brien Smith, MD, FAAN. Smith, epileptologist, and Kost Elisevich, MD, PhD, FRCS(C), FACS, neurosurgeon, co-chair the clinical neurosciences team at Spectrum Health. Smith also is Chair of the Epilepsy Foundation of America.

“It is essential to be able to offer our patients a comprehensive epilepsy program that includes the full range of treatment options, exceptional expertise and, now, an expanded inpatient monitoring unit,” said Dr. Smith. “The inpatient unit enables us to continuously monitor our patients. This is essential in determining the type of seizures a patient is experiencing so that we can select an appropriate treatment option.”

Approximately two-thirds of epilepsy patients have seizures that will be controlled with medications. The other third can often be helped with surgery. The EMU offers continuous inpatient video electroencephalographic (vEEG) monitoring for patients whose seizures are not responding to medications.

Each private room has a video camera with a microphone and special equipment that records a patient’s electrical activity in the brain and changes in behavior. An EMU patient study is conducted over several days using continuous 24-hour recording.

“We write very specific orders for each patient in the EMU. There are actually two video cameras per room so we can use one for close-ups of subtle changes in facial features and eye movements,” Dr. Smith explained. “We reduce or stop their antiepileptic medications, or try other methods to induce seizures. It is important that the seizures occur so we can closely monitor what is happening in the brain to determine if seizures are epileptic or nonepileptic, along with identifying where they originate if the patient is being considered for surgery.”

On average, patients stay in the EMU for five to seven days.

The expansion of the EMU reflects the growth of Spectrum Health’s team of experts.

“We have really ramped up our capabilities in epilepsy,” Dr. Smith said. “The monitoring unit is a significant step, as is the strength and expertise of our neurosurgeons, because it is an important option for many patients.”

In the past year, the epilepsy team at Spectrum Health has more than doubled in size to accommodate the growing population of epilepsy patients in the area. Recent additions include epileptologist Nikesh Ardeshna, MD, director of the adult epilepsy monitoring unit, who also serves on the professional advisory board of the Epilepsy Foundation of America.

“Senior citizens are the fastest-growing segment of the population with epilepsy. The demand for specialized epilepsy care is only expected to increase with our aging population,” added Dr. Ardeshna.

The epilepsy team also includes epileptologists Shan Abbas, MD, and Ayman Haykal, MD, who will be providing services to Spectrum Health patients in Fremont in addition to their work in Grand Rapids. Hayden Boyce, MD, and Sanjay Patra, MD, MSc, both neurosurgeons, recently joined Spectrum Health Medical Group. Neuropsychologist Michael Lawrence, PhD, and neuroradiologists Mark DeLano, MD, Brad Betz, MD, Jeff Hinman, MD, and Manish Kumar, MD, are integral members of the investigational team.

Spectrum Health is a not-for-profit health system in West Michigan offering a full continuum of care through the Spectrum Health Hospital Group, which is comprised of nine hospitals including Helen DeVos Children’s Hospital, a state of the art children’s hospital that opened in January 2011, and 190 service sites; the Spectrum Health Medical Group and West Michigan Heart, physician groups totaling more than 700 providers; and Priority Health, a health plan with 600,000 members. Spectrum Health is West Michigan’s largest employer with more than 18,000 employees. The organization provided $176.5 million in community benefit during its 2011 fiscal year.