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Pediatric Epilepsy Monitoring Unit

Diagnosis and Treatment for Pediatric Epilepsy

NEW YORK (Jun 3, 2013)

A new Pediatric Epilepsy Monitoring Unit at NewYork-Presbyterian Phyllis and David Komansky Center for Children's Health/Weill Cornell Medical Center provides the testing that confirms or eliminates a diagnosis of epilepsy; determines the epilepsy type, as well as the number and location of seizures; and aids physicians in developing an appropriate management plan. Under the leadership of Juliann M. Paolicchi, M.D., Director of the Pediatric Comprehensive Epilepsy Center, the new unit features the latest technology for the evaluation of epilepsy.

uliann M. Paolicchi, M.D.
Juliann M. Paolicchi, M.D.

About Epilepsy Monitoring

"Epilepsy monitoring involves the recording of a child's brain waves by video-electroencephalography – or EEG – to diagnose seizures or epilepsy," says Dr. Paolicchi, a pediatric neurologist and a leading expert in pediatric epilepsy. The Pediatric Comprehensive Epilepsy Center offers the full range of therapies – medication, surgery, implantable devices, and alternative dietary approaches – all in a clinical setting that is comfortable and attentive to the needs of children and their families. "Video and EEG readings are continuously recorded, digitized and stored electronically, which allows for the precise definition of seizure events."

The new two-bed Pediatric Epilepsy Monitoring Unit is located within the neuro Pediatric Intensive Care Unit (PICU), and adds further capability to the already existing three beds on the regular pediatric floor. "Ours is a multidisciplinary collaboration between pediatric neurology and the pediatric ICU," notes Dr. Paolicchi. "This allows patients who are under the care of pediatric neurology to receive their monitoring with the highest and most advanced technology available. Patients who are admitted might be coming in because they have new onset seizures. The monitoring helps us to determine if the events are seizures and constitute epilepsy."

Or a patient might have known epilepsy but is now having new seizures that are not responding to treatment, according to Dr. Paolicchi. "A patient might have had something new going on and is just not as responsive, or their cognition has changed and their mental status is not the same," she says. "This unit also allows us to monitor the child to figure out the reason why.

"What's important about the unit is that it allows us to not only provide a diagnosis," continues Dr. Paolicchi, "but we have the ability to intervene and treat. Because the unit is housed within the PICU, we can move aggressively towards treatment. We are able to use to use higher doses of medication at a more rapid rate because patients can be monitored very closely."

Rapid Treatment

The ability to rapidly treat once a diagnosis is confirmed, says Dr. Paolicchi, is a "a huge advantage to patients. They come in and we have the answer. Fellowship trained pediatric epileptologists read the overnight monitoring studies each day and plan treatment accordingly. If the plan is to continue to capture seizure spells we'll do that. But if the plan is to start treatment, it can be initiated and monitored immediately. There is no lag in between diagnosis and treatment."

Rapid treatment is important to a family who is understandably anxious about what is happening to their child. "Our unit is very patient and family centered," says Dr. Paolicchi. "A parent or caregiver stays by the child's bedside. The parent is essential to our understanding of what's going on. We need the parent to explain their concerns and to describe their child's spells and behaviors so that we can work together to get to the root of what's happening."

The monitoring unit provides a comfortable environment for the child, who is generally monitored for one or two days for a first-time diagnosis, or up to five days for evaluation prior to epilepsy surgery. "The testing is painless and noninvasive and primarily consists of electrodes that are attached to the head to monitor brain activity. Once the electrodes are in place, the child is able to do whatever he or she wants to do. They just have to stay within the confines of their bed. We encourage them to bring their favorite iPad, Game Boy, movies – whatever the parent feels will best entertain the child."

Referrals to the Pediatric Epilepsy Monitoring Unit

Parents may contact the Pediatric Epilepsy Monitoring Unit directly for an evaluation of their child. "For our outpatients, we may often prefer to see them first to set up the best possible plan for when they're admitted," says Dr. Paolicchi. "For a patient that a physician feels is acute or urgent, we can also arrange for immediate admission to the unit. We welcome referring physicians to be in daily communication with our team to review the testing results."

For more information about the Pediatric Epilepsy Monitoring Unit, call (212) 746-3278, or visit the Pediatric Comprehensive Epilepsy Center. You may also view the Pediatric Epilepsy webcast that provides information on what to expect during a visit and treatment.

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