The Epilepsy Surgery Program 
| | Wake Forest University School of Medicine Comprehensive Epilepsy Program is known internationally for the medical management of epilepsy. With the addition of the Epilepsy Monitoring Unit at the Wake Forest University Baptist Medical Center, the program continues a tradition of excellence in the complete evaluation and management of patients with problem epilepsy. Our multi-disciplinary staff includes epileptologists, neurosurgeons, neuropsychologists, nursing specialists, social workers, pharmacologists and EEG technologists. Together, they address all aspects (medical, social and psychological) of the patient with difficult-to-control seizures. |
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Monitoring
Up to 20 percent of patients admitted to epilepsy monitoring units have non-epileptic events. The primary goal, then, is to confirm the diagnosis of epilepsy. Often convention diagnostic techniques are not conclusive. Simultaneous video and electroencephalographic (EEG) monitoring, 24 hours a day in our Epilepsy Monitoring Unit, enable personnel to record and correlate complete clinical behavior, providing the information needed for proper diagnosis and treatment.
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The Facility
Our six-bed unit is located in the Reynolds Tower of North Carolina Baptist Hospital. Each private room contains video-EEG monitoring equipment and is large enough for a family member to remain with the patient at all times. Monitored information is sent to a central control room and recorded for later analysis by epileptologists. Patients may socialize and take part in recreational activities in the facility's pleasant day room while being observed on video and EEG.
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Steven S. Glazier, M.D.
Office: (336) 716-9728
Nights/Weekends: (336) 716-4081
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Steven S. Glazier, M.D.
Aneurysms, Arteriovenous Malformation, Brain Tumors, Carotid Occlusive Disease, Cerebral Revascularization, Epilepsy Surgery, Pediatric Surgery, Spine Surgery
M.D.: 1987, Georgetown University
Residency: 1987-93, Hospital of the University of Pennsylvania
Fellowship: 1993, Nagoya University School of Medicine, Nagoya, Japan |
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Outpatient & Mobile Video-EEG Monitoring
For some, monitoring on an outpatient basis is recommended. For these patients, it is possible to continue video-EEG monitoring on an appointment basis, without the necessity of checking into the hospital. For patients hopsitalized but unable to be transferred to the EMU, mobile monitoring equipment is utilized.
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Medications
Once the diagnosis of epilepsy is established, the physicians and support staff reassess the adequacy of drug treatment for adjustment or change. As an active participant in the development of new anti-convulsant drugs, our Comprehensive Epilepsy Program can offer eligible patients an opportunity to participate in studies of experimental medications.
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Surgery
For patients who are refractory to medication, epilepsy surgery is an option that can dramatically improve the quality of life. In addition to video-EEG monitoring, imaging techniques such as magnetic resonance imaging (MRI), positron emission tomography (PET) and single photon emission tomography (SPECT) help pinpoint the seizure focus even when lesions do not appear on routine imaging. Neuropsychological tests and intracranial EEG electrodes also offer important clues to the seizure focus.
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Once the seizure focus is located, the patient may be a candidate for surgical resection. A temporal lobectomy, which involves the removal of the brain portion responsible for seizure activity, achieves complete seizure control in 70 to 80 percent of patients and a significant reduction in the frequency and severity of seizures in another 15 to 20 percent.
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Other techniques such as corpus callosotomy are performed in selected patients who are ineligible for the resection of brain tissue. In this procedure, the white matter tract connecting the two halves of the brain is cut to halt the spread of seizures and to limit their severity. Significant improvement for this select group has been achieved with this procedure.
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