USF Health Team in Neurology Focuses on VA Patients

This month’s Journal of Clinical Neurophysiology published the work of USF Health’s Selim Benbadis, MD; Heber Varela, MD; and Denise Taylor, DO. The article highlights their two year study with VA patients and showcases the caliber of the university’s medical residents. At the time of the research study, Doctors Varela and Taylor were medical residents in the USF College of Medicine’s neurology program.

“This study was completed by two of our best residents and we’re very proud of them”, said Dr. Selim Benbadis, Professor and Director of the Comprehensive Epilepsy Program, Departments of Neurology & Neurosurgery at USF College of Medicine and Tampa General Hospital. “This is such a motivation for our residents to conduct and publish clinical research. This is one of the most satisfying parts of our jobs as clinicians and educators – watching our residents grow and succeed!”

The team of neurologists studied VA patients from April 2004 to March 2006 focusing on outpatient methods to diagnose seizures – a departure from the hospital inpatient and costly methods commonly used today. By using outpatient EEG-video monitoring for the diagnosis of psychogenic non-epileptic seizures, their work provides important insight into a patient population that is typically misdiagnosed and subjected to years of unsuccessful treatments before receiving an accurate diagnosis.

The study is of particular interest to VA hospitals nationwide because the EEG-video monitoring is considered the “gold standard” for diagnosing non-epileptic seizures but is not easily accessible to them. The USF Health study hopes to provide a viable, outpatient alternative. In the Journal article, the team writes “Epilepsy monitoring units are not readily available for the Veterans Administration (VA) population, and this often requires referrals to off-site epilepsy centers, adding a significant cost to the VA”.

To render assistance to VA patients on an outpatient basis, Doctors Varela, Taylor and Benbadis worked closely with VA patients to trigger and observe their seizures. The sessions were done with the patient’s permission. Each time, doctors explained to the patient what triggering techniques were about to be used. They included deep breathing, verbal suggestion and strobe lights. Patients then described, in detail, what they experienced. In a unique aspect of the study, a family member was also present and consulted to provide further details observed during the patient’s seizure.

“This technique may sound traumatic for the patient and family, but obtaining an accurate diagnosis can save them years of suffering, misdiagnosis and taking the wrong medications. On average, patients go 7 to 10 years before getting an accurate diagnosis”, said Dr. Benbadis. “By giving doctors other testing options, we can give these patients the help they need sooner and dramatically improve their lives.”

Co-authors/USF Medical Residents:
Where are they now? Dr. Heber Varela and Dr. Denise Taylor have since graduated. Dr. Varela is completing his fellowship in Clinical Neurophysiology at the Mayo Clinic in Jacksonville. Dr. Taylor is a fellow in Epilepsy at Emory University in Atlanta.

Writing to us from Georgia, Dr. Taylor said “Epilepsy became my primary interest after working with Dr. Benbadis during my neurology residency at USF. The program helped prepare me for a more focused study in epilepsy by exposing me to a comprehensive epilepsy program including initial diagnosis, medical management, presurgical work-up, neuropsychological evaluation, surgical treatment, and long term follow up. Working on this study developed my understanding that as physicians we have an opportunity, through clinical research, to answer questions that will improve the health care delivery system and the quality of care for our patients.”

Click here for study summary.
Journal of Clinical Neurophysiology, Volume 24, Number 5, October 2007