Sponsored Content: Local treatment, local options from epilepsy unit


THIS ARTICLE IS SPONSORED CONTENT FOR ST. MARY’S HOSPITAL/ BY NANCYLOFHOLM

When Zachary Scott became the first patient in the new Epilepsy Monitoring Unit at St. Mary’s Hospital late this summer, he had been suffering seizures for most of the 22 years of his life.

Scott had consulted numerous physicians in Delta and Montrose where he lived. He had undergone an open-brain study in Denver and suffered a stroke during the procedure. But he and his family still had no answers about the cause of his spells, sometimes dozens a day. Scott would go into states where he would either sit frozen or twirl around in a frenzy. At times, he exhibited the more classic jerking and falling episodes that are most often associated with epilepsy.

Scott spent a week at St. Mary’s in a room with video monitoring devices and alarms.

He was hooked up to monitors that measured the electrical impulses in his brain and heart around the clock. The doses of his anti-seizure medications were lowered so he would be more likely to have episodes.

What was observed by a neurologist during that time brought an unexpected answer to Scott’s family after decades of questions.

In the calm atmosphere of the hospital, Scott had few episodes. When he did, monitoring showed no sign of abnormal electrical discharges in his brain.

That indicated his episodes are not epileptic. They are psychogenic, meaning they are psychological in nature. Such episodes are often tied to stress. Scott’s medications were adjusted, and behavioral changes were prescribed. He and his family had a new way of looking at, and dealing with, his lifelong disorder.

“St. Mary’s was wonderful,” said Scott’s grandmother, Christina Baldwin. “We now have some answers.”

The four-bed Epilepsy Monitoring Unit that Scott pioneered as a patient was added to the 9th-floor neurology wing at St. Mary’s this year after a push by St. Mary’s neurologist Dr. Logan McDaneld. It became possible with the addition of a new St. Mary’s epileptologist, Dr. Marie Collier, who specializes in diagnosing and treating epilepsy. Collier moved from Billings, MT to Grand Junction to run the unit when she saw the large need on the Western Slope: An estimated 500 people in St.

Mary’s treatment area suffer from epilepsy and could benefit from Collier’s expertise.

“This is a very exciting time in the treatment of epilepsy,” Collier said. “Number one – patients are learning they are not alone: People with epilepsy have tended to be very disenfranchised in our society.

And, two, more is being learned about this disease every day. There is a lot that can be done for patients.”

Epilepsy is a very complex disorder with many manifestations. Seizures can include fugue states when sufferers have suspended awareness of their surroundings or lost time. Seizures can be confined to the uncontrollable shaking of a single body part, such as an arm. They can be full-blown episodes known as grand mal when people lose consciousness and have violent full-body muscle contractions.

Collier said the one characteristic that defines epileptic seizures is measurable electrical malfunction in the brain.

“It’s like getting struck by lightning in the head,” Collier said.

Collier calls herself an “integrative epileptologist,” meaning that she turns to much more than medications, devices, or surgeries to control epilepsy.

In her assessments of patients, she studies the role diet, stress, sleep and depression play in the magnitude or prevalence of episodes. Collier also studies the reasons behind the seizures. They can be hereditary or they can happen because of brain injury, infection, tumor or stroke.

When drugs are called for, there are now more than 30 anti-epileptic drugs to choose from. Often, finding the best control for seizures requires a careful mix of medications.

There are also neuro stimulation devices to control seizures. The oldest, called a vagal nerve stimulator, has been in use in the United States since 1997. Three years ago, the Food and Drug Administration approved a new device called the responsive neuro stimulator for treating partial onset epilepsy. This type of epilepsy originates in a specific part of the brain. The device monitors brain signals and provides responsive stimulation automatically through an electrical lead on the brain when it is needed to thwart a seizure.

The opening of St. Mary’s new Epilepsy Monitoring Unit comes at a time when more of these treatment options have become available to patients with epilepsy than ever before – from pharmacology to neuro stimulation to surgery. It also coincides with the projection that an aging population is going to increase the prevalence of epilepsy cases.

After the age of 60, the chance of developing seizures goes up significantly. The Epilepsy Foundation estimates that 1 in 26 people will develop seizures at some point in their lives.

Patients whom Collier determines could benefit from time in the epilepsy unit, will spend seven to ten days under close monitoring. Medications may be lowered and sleep may be interrupted to induce seizures. Padding on beds, monitors and specially trained nurses and technicians in the unit add a layer of safety to seizures that can be dangerous in uncontrolled situations.

“We are creating an emergency situation in a controlled environment,” Collier said.

She said she will also be collaborating with epileptologists in Denver to provide the most comprehensive care for patients.

She may also send some patients to Denver following analysis in the unit because St.

Mary’s will not be doing open brain studies that are sometimes needed in severe cases.

Zachary Scott and his family gather in the hospital room in the new Epilepsy Monitoring Unit at St.

Mary’s Hospital where Scott will stay for a week of observation and tests. From left to right: Stepgrandfather Patrick Duff, patient Zachary Scott, grandmother Christina Baldwin and sister, Ashley Heck.

 


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