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Epilepsy meets its match

Coeur d'Alene Press | UPDATED 5 years, 3 months AGO
| October 3, 2019 1:00 AM

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Kootenai Health has the only accredited epilepsy unit in North Idaho and opened in June. (LOREN BENOIT/Press)

By CRAIG NORTHRUP

Staff Writer

It’s rare to hear someone sound so excited about a vest.

But Judy Hayton cherishes the rare victories her profession provides.

“Because we modeled our [Epilepsy Monitoring Unit] after the Mayo Clinic, we made sure to utilize these vests,” she said. “Since the Mayo Clinic implemented them, their fall rate has gone to zero.”

The special vests that Hayton — manager of neurodiagnostics at Kootenai Health — cheered are designed to help patients with epilepsy stabilize themselves. Kootenai Health has the only accredited epilepsy unit in North Idaho.

“Only 168 labs are accredited nationwide,” Hayton said. “The closest accredited one is in Seattle. While we have four epileptologists in Idaho, Kootenai Health has the only one north of Boise.”

While accredited monitoring units are rare, Hayton emphasized epilepsy is anything but. One out of every 100 Americans is epileptic. The Epilepsy Foundation of Idaho reports more than 22,000 people in our state have the condition.

“It’s definitely more common than people think,” she said.

Epilepsy is characterized as two or more unprovoked seizures within 24 hours. An “unprovoked” seizure is one that happens in the absence of other trauma, such as stroke or brain injury.

“We try to classify the seizures,” Hayton said. “To do that, we need to find where the seizure originated. Is it focal? Is it generalized? Many different things can cause a seizure, such as an electrolyte imbalance.”

Hayton said the challenge of separating epileptic seizures from non-epileptic pseudo-seizures takes a special viewpoint, one not available at most hospitals.

“It’s sort of like a thunderstorm,” she said. “The seizure would be the lightning in the thunderstorm. That’s what we’re looking for: that electrical imbalance.”

Hayton, a USC graduate, said technological improvements in the field have completely changed the way she and her colleagues have approached epilepsy.

“I’ve been in this field 42 years,” she said, “and I’ll tell you: 15 years ago, it was very difficult to accurately diagnose epilepsy. People just didn’t have access to the technology that we have today. It was all analog.”

That conversion to a digital view, one the Epilepsy Monitoring Unit provides, lets staff adjust their vantage point to determine the seizure’s origin in real time. That can include monitoring patients when they’re asleep as well as when they’re awake.

“When you’re asleep,” she said, “your brainwaves change dramatically. We sleep-deprive all our patients because sleep deprivation and other stressors can trigger seizures. From there, we can see much more clearly what is generating the seizure.”

Kootenai Health’s unit, which opened in June, was a project four years in planning. Megan Baar, a Kootenai Health Physician’s Assistant in its Neurology Department the past three years, says she believes the EMU represents a breakthrough.

“I’ve had the opportunity to work at another EMU in the past,” she said. “This EMU here — Kootenai Health’s unit — is the Mercedes of EMUs. It’s top of the line. We’ve been able to integrate equipment with the highest quality of technology. We’ve had aggressive involvement with our epileptologist. We have the ability to continuously monitor the patient, which is unique. Most units don’t offer that.”

Baar added that from a clinical perspective, the patient’s care will improve exponentially.

“The wonderful thing about an EMU done well,” she said, “is that you can make disease-modifying changes to the patient’s management. We can localize the problem and refer for further more definitive testing. We’re actually tailoring [the patient’s] treatment as it’s happening.”

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