History of Epilepsy at UF

WIlder book PhotoThe foundation of excellence in patient care and scientific epileptology at UF was laid by BJ Wilder and RP Schmidt over half a century ago. Drs. Wilder and Schmidt performed a number of early neurophysiologic studies of epileptogenesis; Dr. Wilder (known to friends and colleagues the world over as ‘BJ’) was also instrumental in several pivotal studies that led to the approval of many second generation anticonvulsant medications. Few trainees in the current generation know, for instance, that BJ and his team pioneered the practice of serum anticonvulsant level monitoring and established the concept of therapeutic levels, an example of which is the universally known therapeutic phenytoin level of ‘10-20’.

Over the years, hundreds of UF neurology residents have received training in basic epilepsy care and scores of fellows have completed advanced training in clinical neurophysiology and matured to leadership positions in academic and community practice across the nation. In 1992, the epilepsy surgery program was launched to complement the medical aspects of the program and offer truly comprehensive care for both children and adults with epilepsy at all stages of their illness. Since then, UF’s epilepsy surgery program has performed over 1500 surgical procedures for epilepsy.

Today, we are a National Association of Epilepsy Centers Level IV program that provides comprehensive, compassionate, patient-centered and innovative care for epilepsy. Our expanding team of adult and pediatric epilepsy neurologists partners with an adult and a pediatric epilepsy neurosurgeon and several experienced advanced registered nurse practitioners. We are supported by state-of-the-art facilities in the new NeuroMedicine Hospital at UFHealth, comprising routine EEG, long-term EEG monitoring, inpatient video-EEG monitoring, 3T MR imaging, functional MR imaging and nuclear medicine imaging. We are supported by a dedicated team of neuroradiologists, neuropsychologists, neuropathologists and an academic dietary biochemist. Our multidisciplinary team meets regularly to develop consensus plans for our patients to optimize seizure control and improve the quality of life for patients and their families. We offer advanced pharmacotherapy that include clinical trials of emerging therapies, peripheral (vagus nerve stimulation – VNS) and central (responsive neurostimulation – RNS) neuromodulation and a full range cranial resective, disconnective and ablative (laser interstitial thermocoagulation therapy) procedures. Our long-standing expertise in intracranial EEG monitoring has expanded to include a rapidly evolving stereo-electroencephalography (SEEG) program. While most of our patients live in north and central Florida, many travel from across state and the southeastern United States and beyond.

The UF comprehensive epilepsy program was one of the original three investigational sites for VNS, which was FDA approved for the treatment of refractory focal onset seizures in 1997. We also participated in the multicenter NeuroPace Responsive Neurostimulator (RNS) trial. We were the first center in Florida to implant the RNS after its FDA approval. In addition, the UF is one of the few institutions that has used LINAC (linear accelerator) radiosurgery specifically for the treatment of focal seizures. All these achievements follow the tradition of excellence and innovation set by Dr BJ Wilder and Dr RP Schmidt at the University of Florida in our early years.

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