ECoE: Improving the Health and Well-being of Veterans with Epilepsy - San Francisco VA Health Care System
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San Francisco VA Health Care System


ECoE: Improving the Health and Well-being of Veterans with Epilepsy

Dr. Nina Garga and patient.

Dr. Nina Garga conducts motor exercises with an inpatient.

By Kellie Burdette Mendonca, Public Affairs Specialist
Wednesday, January 11, 2012

 In 2008, by Congressional mandate, the VA revolutionized services for Veterans afflicted by Epilepsy and other seizure disorders.  The VA founded the Epilepsy Centers of Excellence (ECoE) with 16 sites linked to four regional centers.

“The mission of the ECoEs is to offer the best possible Epilepsy care to Veterans throughout the United States with state-of-the-art diagnosis and therapeutic services,” said ECoE National Director Karen Parko, MD. 

The San Francisco VA Medical Center (SFVAMC) opened its Epilepsy Center of Excellence in 2009. We’re part of the Southwest region which also has ECoEs in Los Angeles, Albuquerque, Houston, and San Antonio.  Additionally, we hold a national leadership role.

“Here at the San Francisco VA Medical Center we offer a full complement of services for the advanced evaluation of patients with Epilepsy,” said Neurology staff physician and epileptologist John D. Hixson, MD. “This includes advanced brain imaging techniques to identify potential areas of the brain that may be causing seizures to occur in the first place. This also includes advanced brain wave testing—electroencephalography—which allows us to know what types of seizures a person is having as well as to localize where they may be coming from in the brain.”

“The quality of life is really the most critical part of a patient with any medical condition,” said San Francisco VA ECoE Clinic Director Nina I. Garga, MD. “If you treat the problem without treating the person, you don’t really address their needs. So we take a holistic approach and address all of the aspects of a patient’s life that are affected by their disease.”

“We host monthly support groups, provider calls, patient calls, public talks on various aspects of Epilepsy, and lots of archived educational material is available on our website,” said ECoE National Administrative Director Ryan Rieger, MHPA. The next presentation is January 13 from 1-2 p.m., “Introduction to Epilepsy and Seizures” by Epileptologist Sarah Shalev, MD, in the Auditorium, Bldg. 7, Room 112. It’s free and open to Veterans, patients, potential patients, Veteran caregivers and providers. Lunch is provided. Call (415) 379-5599 to reserve your seat. 

Of 8.3 million Veterans being seen at VA Medical Centers, about 85,000 are diagnosed with seizures or Epilepsy, and three-quarters of these patients are age 50 or older, according to Parko.  Many are Veterans with traumatic brain injuries. “Traumatic brain injury (TBI) is usually a life-long chronic problem,” said Parko, explaining that Epilepsy and seizures may not occur immediately. Approximately 12 percent of Veterans have developed post-traumatic Epilepsy 14 or more years after their TBI.

Each Epilepsy Center is linked with a Polytrauma Center (ours is in Palo Alto) to increase VA’s ability to follow Veterans with moderate to severe TBI who are at the greatest risk for post-traumatic Epilepsy. The sites are developing procedures to identify Veterans with Epilepsy, and to create networks of referrals for Veterans to receive specialized treatment, such as Epilepsy surgery and advanced electro-diagnosis, all within the VA health care system. Video teleconferencing and telemedicine allow Veterans living in rural areas to receive expert care as well, according to Parko.  “If a rural patient needs advanced care or might be a surgical candidate, we send them to San Francisco (VA Medical Center) at no cost to him or her.”

If you are a Veteran with seizures or Epilepsy and are interested in visiting our San Francisco VA Epilepsy Center of Excellence, please speak with your VA doctor, who can determine if you might benefit from visiting us and help set up an appointment.  For more information about the Epilepsy Centers of Excellence, visit:     


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