UAB Epilepsy Center

We are the only fully-accredited Level IV adult epilepsy center in Alabama according to the National Association of Epilepsy Centers. This designation indicates the highest possible level of clinical care for people with epilepsy. We are also one of only two centers in the southeastern United States with a clinical magnetoencephalography (MEG) laboratory, and one of only 21 member sites of the American Clinical MEG Society. The Center receives referrals from throughout the state of Alabama and all neighboring states, resulting in a high patient volume for initial evaluation/diagnosis of seizures as well as for consideration of surgery.

We have all the tools necessary for a comprehensive presurgical evaluation for drug-resistant epilepsy, including: 3/5/7T MRI, fMRI, MEG/MSI, PET, ictal/interictal SPECT/SISCOM, intracarotid sodium amobarbital procedure (Wada), neuropsychological evaluation, intracranial EEG with stereo-EEG or grid/strip electrocorticography (ECoG) with cortical mapping. UAB has state-of-the-art surgical suites with intraoperative MRI for precision laser interstitial thermal therapy (LITT). Patients who are not candidates for curative surgical resection may be offered various other medication-sparing treatments including targeted radiofrequency ablation (RFA), responsive neurostimulation (RNS), deep brain stimulation (DBS), or vagus nerve stimulation (VNS) devices.

Stats:

• 10-bed Epilepsy Monitoring Unit at UAB and 1 bed at the VA, with a plan for expansion to 28 beds in a brand-new facility by mid-2025

• 32 continuous video EEG machines at UAB and 4 EEG machines at the VA

• 5 ambulatory EEG machines

• 2 surgical intracranial EEG machines

• 80-90+ surgical cases performed annually

Epilepsy Subspecialty Clinics and Facilities

Dr. Larry VerHoef has an additional board certification in Neuroimaging through the United Council of Neurological Subspecialties that allows him to read MRI scans as the physician of record, much like a neuroradiolgist. He also has a background in engineering, MRI physics, and Image processing. He has secondary appointments in biomedical engineering and neurobiology. Fellows interested in research and neuroimaging can schedule electives with Dr. VerHoef.

Dr. James (Thom) Houston runs a monthly Concussion Clinic. Which is dedicated to complex concussion cases and prolonged post-concussion syndrome. The goal of the clinic is to address multiple common symptoms related to PCS. We have multiple resources to ensure a comprehensive approach to treatment including specialized optometry services, vestibular therapy, cognitive/speech therapy, and neuropsychological counseling.

Dr. Zennat Jaisni heads the Neuromodulation Clinic, managing devices such as RNS, VNS, DBS for refractory epilepsy patients. We have a significant patient population with RNS and DBS that are managed in this clinic. Research trials as NIH-funded trial for efficacy of RNS in LGS patients and evaluation of bilateral thalamic RNS efficacy in Idiopathic generalized epilepsy patients are underway and these patients will be managed in the specialty neuromodulation clinic. This clinic at our level 4 tertiary center serves populations in adjoining states of TN, MS, FL, GA besides the state of Alabama. Residents and fellows rotate in this clinic to gain understanding and develop skills in managing these patients.

Dr. Jennifer DeWolfe has a Women with Epilepsy Clinic devoted to family planning, contraception, pregnancy, breast-feeding, catamenial seizures, bone health, hormone-related concerns, post-menopausal issues in women with epilepsy. The Women with Epilepsy Clinic is the only one in Alabama, enjoys a robust collaboration with High-Risk Maternal Fetal Medicine, and draws from a large multi-state catchment area. She is also board-certified in Sleep Medicine, which is an optional elective rotation dedicated to neurophysiologic and polysomnographic monitoring and neurologic sleep disorders including parasomnias, sleep-related movement disorders, hypersomnias, sleep-related breathing disorders, and the interaction of sleep disorders and epilepsy.

Dr. Ashley Thomas heads the Epilepsy Genomics Clinic, which is a referral-based consultation clinic that utilizes a multidisciplinary approach, with all patients seeing an epileptologist in conjunction with a genetic counselor. The epileptologist takes a thorough seizure and neurodevelopmental history and performs a neurological examination, while the genetic counselor obtains a syndrome-specific family history and explains genetics concepts and inheritance patterns. The genetic counselor then discusses testing options and the associated risks, benefits, and limitations with patients and their families as well as sets reasonable expectations, obtains informed consent for the testing, and addresses the psychosocial implications of genetic testing. A plan for genetic testing is determined together by the epileptologist and genetic counselor and then coordinated between the genetic counselor, the patient’s insurance company, and the genetic testing facility. The identification of certain genetic diagnoses can result in precision medicine approaches, such as the recommendation of specific treatment modalities that would not otherwise be offered to patients, such as targeted anti-epileptic drugs for the exact genetic channelopathies identified through genetic testing.

Drs. Quynh Vo and Omar Tamula collaborate with Drs. Kathryn Lalor and Katherine Thaggard, from Pediatric Neurology, to run the Epilepsy Transition Clinic. We facilitate a standardized and streamlined process for young adults with epilepsy transferring care from pediatric to adult health care. We also participate in the transition multidisciplinary clinic (STEP) for patients with more complex medical needs. Fellows rotating will learn about topics relevant to young adults with epilepsy.

Dr. Tyler Gaston is the Director of the Neurobehavioral (NBT) Clinic at UAB and the VA, providing 12-week structured, multi-modal, and disease-specific treatment for Psychogenic Non-Epileptic Seizures (PNES) and Epileptic Seizures. The clinic serves to improve recognition and treatment of patients with psychogenic non-epileptic seizures (PNES).