The Epilepsy Division physicians include Anto Bagić, MD, PhD, FAES, FACNS; Refeed Alkawadri, MD; Niravkumar Barot, MD, MPH; James Castellano, MD, PhD; Joanna Fong, MD; Vijayalakshmi (Viji) Rajasekaran, MD; and Alexandra Urban (Popescu), MD, FAAN, FAES. Academic members are Arun Antony, MD; Maria E. Baldwin, MD and Anne Van Cott, MD FAAN.
Staff members of the Epilepsy Division include Jill Bischoff, CRNP; Kimberly Fleischer, RN; Hallie Gilbert, PA; Charmelle Glover, MA and Alexus Widmer, PA.
The Epilepsy Division provides the following clinical services: Subspecialty Epilepsy Clinics, Epilepsy Monitoring Unit (EMU; Director: Anto Bagić, MD, PhD), EEG Laboratory Services (Director: Alexandra Urban, MD), Continuous EEG Service (Director: Joanna Fong, MD), and Presurgical Evaluation Service (Director: Niravkumar Barot, MD, MPH). These services are provided in concert with the University of Pittsburgh Comprehensive Epilepsy Center (UPCEC)[LD1] .
The epilepsy clinical care facilities of the UPCEC and UPMC include:
- Eight adult epilepsy monitoring unit (EMU) beds for long- or short-term continuous closed-circuit television/electroencephalographic (CCTV/EEG) monitoring. Adult UPMC EMU is in Presbyterian University Hospital (PUH) and is among selected EMUs equipped with remotely controlled automatic SPECT injectors.
- Eight pediatric epilepsy monitoring unit (EMU) beds for long- or short-term continuous closed-circuit television/electroencephalographic (CCTV/EEG) monitoring. Pediatric UPMC EMU is in Children's Hospital of Pittsburgh (CHP) and was one of the first EMUs in the Country equipped with remotely controlled automatic SPECT injectors.
- Adult and pediatric outpatient ambulatory care facilities.
- Dedicated adult and pediatric VNS Clinics.
- Dedicated adult RNS Clinic.
- Adult and pediatric EEG laboratories.
- Ambulatory digital EEG capabilities.
- Adult Continuous ICU EEG Monitoring Service.
- Pediatric Continuous ICU EEG monitoring capabilities.
- State-of-the-art neurosurgical operating rooms.
- PET scanning facilities.
- Anatomic and functional MRI facilities with 3.0 and 7.0T scanners (including MRI spectroscopy).
- SPECT scanning facilities (for ictal and interictal studies).
- Advanced image processing capabilities (for subtraction SPECT studies, MR planar image reconstruction, and MR surface reconstruction for surgical cases).
- A state-of-the-art magnetoencephalography (MEG) facility featuring 306 sensors for whole head MEG recording, and 128 channel EEG recording capabilities.
The facilities at the center and expertise of the staff enable the staff to:
- Establish a definitive diagnosis in patients with paroxysmal symptoms of uncertain cause.
- Establish optimal medication regimens to maximize seizure control and minimize side-effects.
- Identify patients with medication-resistant seizures for surgical treatment alternatives
- Localize epileptic brain regions for resective surgery.
- Map vital or eloquent brain areas in relation to the epileptogenic area.
- Perform epilepsy surgery.
- Conduct detailed neuropsychological evaluations.
- Monitor antiepileptic drugs and their metabolites in relation to seizures, cognitive function, other drugs, and environmental or physiological factors that affect antiepileptic drug disposition.
- Conduct clinical trials of investigational new drugs.
- Diagnose and treat psychogenic seizures.
- Offer a range of rehabilitation and psychosocial services and referrals.
Epilepsy Division faculty members are involved in multiple research efforts ranging from sophisticated electrophysiological investigations (e.g. Dr. Alkawadri), human imaging studies (e.g. Dr. Bagić), effects of seizure medications on maternal outcomes (e.g. Dr. Bagić), to role of continuous EEG in treating acutely ill patients in the ICU (e.g. Dr. Fong), acute treatment of seizures (e.g. Dr. Bagić), VNS Registry (e.g. Dr. Bagić), and RNS-based investigations (e.g. Dr. Urban). The key intra-institutional collaborative efforts are with the Laboratory of Jorge Gonzalez-Martinez, MD, PhD (Department of Neurosurgery), Laboratory of Shawn Sorrells, PhD (Department of Neuroscience) and Laboratory of Mike Modo, PhD (McGowan Institute for Regenerative Medicine). Multiple other collaborative research interactions are cultivated through the Brain Institute and Center for Neural Basis of Cognition (CNBC). Traditionally productive collaborations with the Carnegie Mellon University (CMU) are currently mainly through the CMU Biomedical Engineering headed by Dr. Bin He.
The new chapter in research at UPMC and Pittsburgh neuroscientific community starts this Spring with the arrival of the internationally eminent epileptologist and conceptual neuroscientist Patrick Y. M. Chauvel, MD who will serve as a Scientific Director of the Neural Networks Disorders Program (NNDP) of UPCEC and Neurological Institute.
Faculty members are engaged in various national academic and professional efforts through the American Epilepsy Society (AES), National Association of Epilepsy Centers (NAEC), American Clinical MEG Society (ACMEGS), American Clinical Neurophysiology Society (ACNS), American Academy of Neurology (AAN), American Board of Psychiatry and Neurology (ABPN), etc. For example, Alexandra Urban, MD is a member of the ABPN Epilepsy Committee, Vijayalakshmi (Viji) Rajasekaran, MD is a member of the AAN Residency In-service Training Examination (RITE) Advisory Council, etc. An example of our international professional engagements is Dr. Bagić’s initiative focused on defining the first internationally developed and accepted clinical practice guidelines (CPG) for MEG under the auspice of the International Federation of Clinical Neurophysiology (IFCN).