Inside Pediatrics Winter 2015

our excitement about the new technique with determining who’s the best candidate, and is it truly better or just a good tool for a subset of kids.” Future plans for the epilepsy program include expanding the number of epileptologists on staff and acquiring additional technology that will offer less invasive treatment methods, such as laser and thermal ablation. Goyal also wants to see greater strides in reducing the

magnetoencephalography (MEG) at the University of Alabama at Birmingham (UAB) adjacent to Children’s. “In the evaluation, we also consider the seizure semiology,” Goyal said. “We want to know what the patient does during the seizure, which side of the body exhibits more movement, whether the patient can answer questions during the seizure. The semiology, the imaging and the findings of the neuropsychologist all help us determine which part of the brain is the source of the seizures.” Once the evaluation is complete, the results are presented to and discussed by the entire team to determine the treatment plan. “Treatment is completely customized for that particular child,” Goyal said. Blount said 70 to 75 percent of the subset of patients who undergo epilepsy surgery at Children’s are cured or see improvement, but the team is striving for life-changing results in every patient with epilepsy. New technology recently added to the Children’s arsenal is expected to help reach that goal. Through a special cooperative arrangement with UAB, Children’s is using the ROSA robotic device for stereotactic EEG procedures to pinpoint the location and cause of the patient’s seizures. The robotic device enhances the surgeon’s ability to place a large number of probes more accurately, quickly and safely. “The ROSA allows us to stereotactically place electrodes in deeper structures of the brain, such as the insula, which increases our understanding of seizure propagation,” Goyal said. “We’ve never before been able to assess the insula because it’s such a deep part of the brain, so we have underestimated its role in epilepsy. We hope this knowledge will translate to better outcomes.” Children’s of Alabama is one of fewer than 10 pediatric medical centers in the U.S. currently using the robotic device for SEEG, which is being adopted worldwide. Both Goyal and Blount said they’re still evaluating the technology. “We’re in the early part of learning about SEEG,” Blount said. “We need to strike a balance between

still-prevalent stigma associated with epilepsy by further educating the public about the disorder.

More information is available at www.childrensal.org/epilepsy .

Brooke McDonald, one of the EEG technicians in Children’s EMU, prepares a patient for VEEG. As a member of the epilepsy team, McDonald works with six to eight other EEG technicians, several nurse clinicians, three epileptologists, two neurosurgeons who specialize in epilepsy surgery and a full complement of nurses on the 8-bed specialized unit.

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