The Johns Hopkins Epilepsy Center

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Neurological evaluations are conducted both in the Johns Hopkins Neurological Consultation Clinic and in the inpatient Epilepsy Monitoring Unit (EMU). The Neurological Consultation Clinic is housed on the 5th floor of the Johns Hopkins Outpatient Center, located at 601 North Caroline Street in Baltimore, Maryland, 21287.

If inpatient monitoring proves necessary, the Epilepsy Monitoring Unit is located on the 8th floor of the Meyer Building at the Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, Maryland, 21287.

The following information may be helpful to you in making the necessary arrangements for a neurological evaluation at the Epilepsy Center.

RECORDS
It is recommended that medical records be sent before the visit, or that they be brought along at the time of the visit. Whenever possible, the patient should bring the actual films of previous MRI's and/or CAT scans and the EEG tracings from previous recordings, especially those showing an abnormality. We emphasize that we would like review the actual EEG tracing whenever possible, not just the report, especially when there is an abnormality.

We also request patients to bring names, addresses, and phone numbers of all health care professionals who should receive letters regarding our findings and suggestions.

WHAT TO EXPECT

The patient should expect to spend anywhere from two to six hours or more at the Outpatient Center, depending on the patient's medical problems. Many patients require an EEG, which takes about an hour, and laboratory work to check anticonvulsant levels. In addition to seeing an epileptologist, the patient may see other medical personnel participating in the patient's care and evaluation. Our epilepsy group works together as a team in providing comprehensive care.

WHAT TESTS ARE REQUIRED FOR DIAGNOSIS?
The electroencephalogram (EEG) often is crucial in confirming the diagnosis of Epilepsy. However, just as patients don't always have seizures, so EEGs don't always show the kinds of abnormal brain activity which determines the kind of Epilepsy a patient may have. Because of this, it is sometimes necessary to record the EEG over a period of hours or days. Through this continuous EEG monitoring, we are more likely to find a patient's EEG seizure patterns. Video monitoring can be done at the same time so that the activities of a patient during a seizure can be "matched up" with the EEG recorded at the same time. Other diagnostic tools such as blood tests, CT (computed transaxial tomographic) scans, MRI's (magnetic resonance imaging), PET (positron emitted tomographic) scans, SPECT (single photon emitted computed tomography), and neuropsychologic assessments are also helpful in diagnosing problems related to seizures in specific cases.

What Happens Next?
After an evaluation has been performed, a plan of care is developed to include all the services a patient may require. We will inform you if additional testing is needed, or make recommendations regarding adjustments to current treatment regimines. We will make every effort to work in conjunction with you and your primary physician.