Texas Comprehensive Epilepsy Program
The Texas Comprehensive Epilepsy Program, the leading program in the southwestern United States for the diagnosis and treatment of epilepsy in patients of all ages, has seen phenomenal growth both in volumes of medically and surgically treated patients and in numbers of faculty. Affiliated physicians now include six full-time adult and three full-time pediatric epileptologists. A collaborative effort between Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital and McGovern Medical School at UTHealth, the program is the premier Level IV National Association of Epilepsy Centers-certified program in Houston.
Board-certified neurologists and neurosurgeons diagnose and treat more than 1,800 pediatric and adult patients each year for seizure disorders. Genetic anomalies, brain trauma, structural abnormalities, stroke and brain tumor rank among the top underlying causes of epilepsy, but because seizures manifest differently among individuals, specific determination of the origin of seizures is crucial to planning the most effective treatment for individual patients.
Once a diagnosis is made, surgery may be advised as part of a treatment plan. Surgical treatment options can include vagus nerve stimulation (VNS), focal cortical resection, lobectomy, hemispherectomy and corpus callosotomy. The program’s surgical complication rates have remained extremely low over the past nine years. At the current time, the Institute’s affiliated epilepsy surgeon has performed more than 500 craniotomies for the treatment of epilepsy, with a zero percent mortality rate and a very low rate of permanent morbidity.
Affiliated physicians are also leaders in innovative surgical approaches for epilepsy, with new surgical approaches and technologies implemented in the past two years, including stereoelectroencephalography (SEEG), robotic SEEG and MR-guided laser interstitial thermal therapy (Visualase®). The Mischer Neuroscience Institute is a pioneering site for the latter technique – the application of laser surgery for well-delineated focal epilepsies – with carefully selected patients treated in a highly advanced, minimally invasive fashion that ablates the seizure focus. In addition to using the Visualase technique for the treatment of temporal lobe epilepsy associated with hippocampal sclerosis, physicians use it in novel ways, including the ablation of deep-seated periventricular nodular heterotopias.
The program is the second epilepsy program in the country to perform robotic SEEG, a technique that helps localize the seizure focus with precision and in a minimally invasive fashion. The safety and efficacy data reported by affiliated physicians following all types of surgical intervention for epilepsy are excellent. They will also be initiating treatment with a newly FDA-approved technique for responsive neuromodulation (NeuroPace®).