The University of Pittsburgh Epilepsy Center continues to provide state-of-the-art diagnostic and treatment services to adults and children with uncontrolled seizures. The center is a joint program combining the resources of the University of Pittsburgh, the University of Pittsburgh Medical Center, and Children's Hospital of Pittsburgh. Established in 1986, it provides regional referral and consultative services to Pennsylvania, Ohio, West Virginia, and beyond. Staff specializes in the evaluation and treatment of patients with forms of epilepsy that are difficult to diagnose or manage.

The center includes clinical and research facilities for adults and children. Adult epilepsy is studied and treated in the University of Pittsburgh Medical Center facilities in the Oakland section of Pittsburgh. Research conducted at the Epilepsy Center has contributed to the introduction of seven new antiepileptic drugs over the past decade.

The epilepsy clinical care facilities of the University of Pittsburgh Epilepsy Center and the University of Pittsburgh Medical Center include:

• Four pediatric and four adult epilepsy monitoring unit beds for long- or short-term continuous closed-circuit television/electroencephalographic (CCTV/EEG) monitoring
• Pediatric and adult outpatient ambulatory care facilities
• Pediatric and adult EEG laboratories
• Ambulatory digital EEG capabilities
• Continuous ICU EEG monitoring capabilities
• State-of-the-art neurosurgical operating rooms
• PET scanning facilities
• Anatomic and functional MRI facilities (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 magnetoencephalogram (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 allow 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

Recent research conducted by Epilepsy Center faculty has resulted in several publications. Epilepsy faculty recently published articles concerning advanced methods for patient position tracking and video data compression in patients undergoing long-term video-EEG monitoring. Dr. Anne Van Cott and colleagues published a paper reporting the results of a major pivotal randomized controlled clinical trial dealing with antiepileptic drug therapy in elderly persons with new onset epilepsy. She also published a paper concerning benign EEG variants. Dr. Anto Bagic and colleagues published papers concerning 5-HT1a receptors, as assessed by positron emission tomography, in the brains of patients with epilepsy, and a paper concerning cortical excitability during prolonged antiepileptic drug therapy and drug withdrawal. Dr. Richard Brenner published articles concerning interpretation of the EEG in stuporous and comatose patients, and on increasing the diagnostic yield of EEG recordings.

Other recent and ongoing research includes collaborative efforts between the Departments of Neurology and Neurosurgery. This research includes an NIH-sponsored pilot trial of radiosurgical treatment for mesial temporal lobe epilepsy. Another NIH-funded collaborative research endeavor involves new methods of video-EEG data compression; initial results of this ongoing work have been presented at national and international symposia.

Recent changes include the addition of Dr. Anto Bagic to the faculty of the Departments of Neurology and Neurosurgery beginning July 1, 2005. Dr. Bagic was formerly a senior fellow at the National Institutes of Health in Bethesda. He now serves as an attending neurologist (epileptologist) in the Epilepsy Division and as director of the new Center for Advanced Brain Magnetic Source Imaging (CABMSI) at UPM Presbyterian. The CABMSI features a 306 channel whole head magnetoencephalography (MEG) unit with the capacity for simultaneous recording of 128 channels of EEG. With the addition of the CABMSI, the University of Pittsburgh Medical Center is one of the first facilities in the world to offer whole head MEG evaluations to intractable epilepsy patients, and to other patients with various brain disorders.