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Hospital's epilepsy program given top designation

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Winchester Medical Center Neurologist and epileptologist Dr. Paul D. Lyons stands in front of test results of an epileptic patient during a Thursday news conference. Rich Cooley/Daily

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Rex Terwilliger, 47, of Winchester, an epileptic patient, shows a scan of his brain. Terwilliger is among the patients of The Virginia Comprehensive Epilepsy Program in Winchester who had surgery to treat seizures. The program was recently designated a Level 4 Epilepsy Center. Rich Cooley/Daily

By Kim Walter -- kwalter@nvdaily.com

The Virginia Comprehensive Epilepsy Program in Winchester was recently named a Level 4 Epilepsy Center by the National Association of Epilepsy Centers, making it one of three in the state with the top designation.

The program is a collaboration of the Winchester Medical Center and two local practices, Winchester Neurological Consultants, Inc. and Virginia Brain and Spine Center, Inc. Being named a level 4 center means it provides intensive testing, monitoring and treatment options to patients of all ages.

Dr. Paul Lyons, a neurologist and epileptologist, and Dr. Lee Selznick, a neurosurgeon, work closely as a team with patients, from diagnosis to treatment and recovery.

"About one percent of the population is affected by epilepsy ... it's not a rare condition," Lyons said. It is the third most common neurological disorder in the United States, yet epilepsy is also among the least understood of major chronic medical conditions.

"The cornerstone of treatment for epilepsy is an accurate diagnosis," he said. To assure a patient is properly diagnosed, Winchester's program conducts rigorous testing and evaluations. Lyons said that once diagnosed, it still has to be determined what kind of medication is best for that particular patient.

While major breakthroughs have happened in epilepsy medication in the past few years, Lyons said that there are still about 16 types, and many of them come with side effects.

"Of those 2.2 million Americans with epilepsy, about 800,000 of them have monthly, weekly, daily seizures that can not be stopped with medication," he said. The program has been able to develop methods of treatment including hormonal, dietary and surgical.

Epilepsy surgery has proved most successful in helping patients live seizure free, Lyons

"Once a patient has failed two medications, their probability of being seizure free is five percent, but that's where Dr. Selznick and his team comes in," he said. "Surgery will give patients a 50 to 80-percent chance of being seizure free."

Epilepsy surgery is a six to eight month process, as physicians have to find a very specific spot on the brain that can be removed or disconnected to stop the seizures.

Selznick explained that the whole procedure includes several surgeries, as well as forced but monitored seizures to better pinpoint where in the brain he should operate.

The program, which has been in Winchester going on five years, currently monitors 17 cases, with 16 of them undergoing surgery.

"Of those 16,15 of them are seizure free," Selznick said.

Rex Terwilliger, 47 of Winchester, is one of those 15 patients. He was diagnosed with epilepsy four years ago, and hasn't had a seizure since early December, and that was a necessary one for final data collection.

"I'd always had this fear of going out in public ... people don't understand it, and it scares them," he said of his epilepsy experiences. "It made me feel bad."

Despite sometimes having five or six seizures a day, Terwillinger wasn't scared before his surgery.

"The staff here was amazing, they made me feel very comfortable," he said. "And a week after my surgery, I was out and about."

He said he's an major advocate for epilepsy awareness and the Winchester program, which is also one of only two in the nation that are not academic centers.

"The surgery is a frightening thing, and it takes a lot of courage to do what he did," Lyons said of Terwillinger. "But when you see the outstanding changes that come from the treatment, it makes it all worth it."



both of these drs' are great.my husband had the surgery,spent 3 weeks in the hospital but the outcome was worth it.


This is great for people that have the option for surgery. But what the article fails to mention is that not everyone that is epileptic has the option to be a candidate for surgery. I'm a 40 yr old female and my seizures are not localized or under control. Taking 25 pills a day and a VNS to at least try to help stop my seizures from going into convulsions when i feel them coming. But for those that this treatment helps CONGRATS and i hope you live a seizure free life, enjoy driving.

Anyone getting a cerebral MRI read at this department is strongly encouraged to have someone else take a look at it. A recently read scan and subsequent report of a family member was riddled with errors. The written report was comical even to the layman.

Jeanette, I have a 36 year old daughter that has the same problem. She has multiple seizures each week, is on as many as 5 medications, has the VNS, and still the seizures are not under control. Her seizures come from several different areas of the brain, so she is not eligible for surgery, either. I know what you are going through. There is so little understanding.

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