Services at the Comprehensive Epilepsy Program
Our physicians are specialists in identifying and treating specific types of seizures. In addition to the precise identification of types of epileptic seizures, we also diagnose non-epileptic seizures, which are a very common condition that mimics epilepsy. Having psychological causes, they are diagnosed and treated in collaboration with the Division of Neuropsychiatry and Behavioral Neurology. Accurate, complete diagnosis is critical in determining an optimal treatment plan for patients suffering from seizure disorders.
In addition, our epilepsy nurse coordinator provides guidance and education to patients undergoing epilepsy treatment, from the first diagnostic stages to follow-ups.
Patients may be referred to our center for:
- Diagnostic Evaluation to determine whether seizures are epileptic or non-epileptic. Long-term video-EEG monitoring (LTM), regionally available only at Rhode Island Hospital, is used to secure the precise diagnosis and to direct future treatment options
- Evaluation to determine whether patients could benefit from surgery or a dietary approach or a different course of medication to manage their epilepsy
- Medication Management to ensure that medications are precisely tailored so that patients receive the most effective type and dosage to control their seizures
- Acute Inpatient Care and long-term monitoring for patients with persistent acute seizures that are resistant to medical management
- Emergency Treatment in the intensive care unit (ICU) if seizures are severe and life-threatening, or if they occur in the context of other medical or neurologic conditions such as encephalitis, stroke, hemorrhage, or cancer
- Surgical Treatments may be recommended for patients who don’t respond to medication and have seizures that can be localized to a particular location in the brain (focal epilepsy)
We have specialists in all areas of epilepsy care, who have expertise in treating patients with special concerns, such as:
Women with concerns about pregnancy or contraception
Elderly patients, who may also be more sensitive to side effects and have unique metabolic concerns that impact their medical management
Pediatric patients, for whom treatments need to be carefully tailored to maximize seizure control and minimize impact on cognition and learning, among other concerns
Developmentally disabled patients, who may need support in administration of medication, adherence to schedule, and monitoring of effectiveness and possible side effects
Our group of pediatric epileptologists, led by director John N. Gaitanis, has extensive expertise in treating children with epilepsy, and they see outpatients in the child friendly environment of the Children's Neurodevelopmental Center (CNDC).
Coordinating Care for Patients
Sandra Sylvestre, RN, CNRN, is the epilepsy nurse coordinator at the Comprehensive Epilepsy Program (CEP) at Rhode Island Hospital. In this role, she provides guidance and education to patients undergoing epilepsy treatment, from the first diagnostic stages to follow-ups.
When a patient is first referred to the CEP, Sylvestre will connect them to the appropriate contact and aid them in booking the correct initial appointment. When pediatric or adult patients are referred for long-term EEG monitoring, Sylvestre coordinates with the patient’s health insurance to ensure the procedures are covered, as well as coordinating between the hospital units and with the patient’s family to find the optimal time for their inpatient stay. Sylvestre also triages calls in case any patient has an emergency, concern or question and needs a timely, accurate response.
Patient education is a huge role for the epilepsy nurse coordinator. Before a patient undergoes treatment, Sylvestre educates the patient and family on what epilepsy is, including the different types of seizures and warning signs. If a patient is recommended surgical treatment, Sylvestre ensures the patient understands all the surgery options and devices available to them, and can make a well-informed decision about their treatment.
At monthly multidisciplinary meetings, Sylvester and the CEP team assess all current patients, making sure they have had all necessary testing done, planning any additional tests, recommending treatment, and discussing how postoperative patients are progressing.
Sylvestre also oversees all patients who receive vagus nerve stimulation (VNS). She is trained to program all VNS devices for each patient’s individual condition, turn them on or off as needed, and provide any check-ups for the devices.
The most important part of her role, Sylvestre says, is letting patients know that she is there for them. If they have any concerns, needs or questions, they can reach out to her and she will always answer. Her role is to help make what can be an overwhelming and difficult process as easy as possible for all patients and their families.