The Neuroscience Institute at the new Le Bonheur Children’s Hospital features technology and space designed to improve patient care and make families more at home. The new building features some of the following: n A dedicated Neuroscience unit features 24 private patient rooms with a specially trained nursing staff. Rooms provide sleeping space for two parents, and include a high-definition, 32-inch flat screen television that physicians and nurses use to show educational programs specific to a child’s diagnosis. n Ten rooms on the Neuroscience floor are equipped for epilepsy monitoring with wireless technology that provides constant EEG monitoring. The new technology includes amplifiers which, when worn outside the room, can record up to 26 hours of monitoring information. n Neurologists are able to record up to 256 channels of EEG information, digitalized at up to 4000 hertz. Dedicated EEG technologists are present 24 hours a day, 7 days a week. n Magnetocephalography technology provides advanced options for diagnosis and treatment, using magnetic fields generated by neuronal activity in the brain to locate sources of activity. n Large operating rooms feature touch-screen computer panels, flat-screen mobile monitors, and a camera in each room that allows a remote access view of what’s happening inside the OR. Surgeons have access to live Web casting capabilities during surgical procedures and can take photographs and record surgeries. n A $7-million intraoperative MRI in the operating suite provides high resolution images before, during and after surgery without requiring surgeons to move the patient from the surgical table. n Truevision 3-D technology in the operating room converts optical view of the surgical microscope to a digital 3DHD image, displaying video on a 46-inch monitor inside the OR. A 3DHD video recording accurately captures the surgical view, making it ideal for teaching. n A playroom on the Neuroscience floor is designed especially for children who suffer from seizures. Wireless monitoring, cameras, soft-cornered furniture and rubber flooring create a safe space for children to play. Child life services are also based on the unit. n A physical therapist is based on the unit, and a rehabilitation room allows patients to receive physical, occupational and speech therapy without leaving the floor. n A family room on the Neuroscience unit provides a space to gather and relax. Wireless internet allows parents to connect with families and work while away from home. The unit offers comforts like a laundry room and kitchen. New technology, family resources enhance Neuroscience Institute Spring 2011 Brain Waves Neuroscience Institute Referrals: 888-890-0818 www.lebonheur.org/ neuroscience A pediatric partner with the University of Tennessee Health Science Center/College of Medicine and St. Jude Children’s Research Hospital Memphis, Tennessee
Transcript
The Neuroscience Institute at the new Le Bonheur Children’s Hospital features technology and space designed to improve patient care and make families more at home. The new building features some of the following:
n A dedicated Neuroscience unit features 24 private patient rooms with a specially trained nursing staff. Rooms provide sleeping space for two parents, and include a high-definition, 32-inch flat screen television that physicians and nurses use to show educational programs specific to a child’s diagnosis.
n Ten rooms on the Neuroscience floor are equipped for epilepsy monitoring with wireless technology that provides constant EEG monitoring. The new technology includes amplifiers which, when worn outside the room, can record up to 26 hours of monitoring information.
n Neurologists are able to record up to 256 channels of EEG information, digitalized at up to 4000 hertz. Dedicated EEG technologists are present 24 hours a day, 7 days a week.
n Magnetocephalography technology provides advanced options for diagnosis and treatment, using magnetic fields generated by neuronal activity in the brain to locate sources of activity.
n Large operating rooms feature touch-screen computer panels, flat-screen mobile monitors, and a camera in each room that allows a remote access view of what’s happening inside the OR. Surgeons have access to live Web casting capabilities during surgical procedures and can take photographs and record surgeries.
n A $7-million intraoperative MRI in the operating suite provides high resolution images before, during and after surgery without requiring surgeons to move the patient from the surgical table.
n Truevision 3-D technology in the operating room converts optical view of the surgical microscope to a digital 3DHD image, displaying video on a 46-inch monitor inside the OR. A 3DHD video recording accurately captures the surgical view, making it ideal for teaching.
n A playroom on the Neuroscience floor is designed especially for children who suffer from seizures. Wireless monitoring, cameras, soft-cornered furniture and rubber flooring create a safe space for children to play. Child life services are also based on the unit.
n A physical therapist is based on the unit, and a rehabilitation room allows patients to receive physical, occupational and speech therapy without leaving the floor.
n A family room on the Neuroscience unit provides a space to gather and relax. Wireless internet allows parents to connect with families and work while away from home. The unit offers comforts like a laundry room and kitchen.
New technology, family resources enhance Neuroscience Institute
Spring 2011
Brain WavesNeuroscience Institute
Referrals: 888-890-0818
www.lebonheur.org/neuroscience
A pediatric partner
with the University
of Tennessee Health
Science Center/College
of Medicine and
St. Jude Children’s
Research Hospital
Memphis, Tennessee
StudieS inveStigate Seizure treatment
for teenS
Researchers at Le Bonheur Children’s are part of two multi-centered drug studies aimed at finding new treat-ments for partial onset seizures in teenagers. This continues the tradition of involvement in the evaluation of new treatments for epilepsy.
The first project will study the seizure drug perampanel, a novel compound (the first to work at the AMPA receptor) from drug maker Eisai that has proven useful for partial onset seizures in adults. Funded by Eisai Medical Research, the new study will test perampanel as an adjunct therapy in patients ages 12-18 years. The randomized, double-blind study allows for enrollees to be on one to three other seizure drugs, said Le Bonheur Children’s Neuroscience Institute Research Coordinator Michelle Ellis, RN.
The second study will evaluate eslicar-bazepine acetate when used as the sole drug in treating partial onset seizures in patients ages 16-18 years. The double-blind, open-label study is also part of a multi-center trial aimed at finding alternative treatments for older children who suffer from seizures. Funded by Sepracor, ideal enrollees in the study have been on other seizure drugs for some time. Unlike the perampanel study, teens enrolled in this study will wean off of other seizure drugs and transition to taking the new medicine, by itself.
James Wheless, MD, director of the Neuroscience Institute at Le Bonheur Children’s, will serve as principal investigator for both studies. He has now been involved in more than 80 studies of new seizure medications, spanning the last 25 years, and believes that there is a need to continue to find better and safer compounds to treat epilepsy in children.
These studies will evaluate the two newest compounds and give physicians at Le Bonheur Children’s Hospital an opportunity to be among the first doctors in the country to utilize these medicines.
Greater Mid-South Pediatric Neurology Update set for May 6-7
T he fifth annual Greater Mid-South Pediatric Neurology Update is set
for May 6-7 at The Westin Memphis, Beale Street.
The seminar has been designed to encompass state-of-the-art practices
and trends in treating the pediatric neurology patients. Faculty who are both
clinically and academically oriented will address relevant issues and provide
valuable information and insight into situations commonly presented to
subspecialists in pediatric neurology. This will be performed using case-
based learning and didactic lectures with time for questions and answers.
The seminar also includes a reception and tour of Le Bonheur
Neuroscience Floor and Epilepsy Monitoring Unit.
James Wheless, MD, is the course director and the director of the
Neuroscience Institute at Le Bonheur Children’s Hospital.
James Wheless, MD
Topics include:l Tourette’s & Tic Disorders: A Clinical Update – John Walkup, MD,
professor of psychiatry, director Division of Childhood & Adolescent Psychiatry, Weill Cornell Medical College, New York Presbyterian Hospital
l Neurology (MRI) Case Review: Images to Know! – Amy McGregor, MD, assistant professor, Department of Pediatric Neurology, University of Tennessee Health Science Center and Zoltan Patay, MD, chief, Section of Neuroimaging, Department of Radiological Sciences, St. Jude Children’s Research Hospital
l Epilepsy is More than Seizures: Recognizing & Treating Co-Morbidities – Greg Holmes, MD, chair, Department of Neurology, Dartmouth Medical School
l Epilepsy Surgery Evaluation: Use of Newer Technologies (MEG, fMRI, DTI, HD-EEG, rTMS) – James Wheless, MD, professor and chief of Department of Pediatric Neurology, University of Tennessee Health Science Center; director of Le Bonheur Comprehensive Epilepsy Program and Neuroscience Institute.
l Pediatric Anxiety & Mood Disorders: Recognition and Treatment – John Walkup, MD,
l Pediatric Sleep Disorders & the New Guidelines – Merrill Wise, MD, Mid-South Pulmonary Associates
l Cognition in Childhood Epilepsy: Importance of Seizures, Spikes and Anti-Epileptic Drugs – Greg Holmes, MD
l Intraoperative MRI: Use in Pediatric Neurosurgery – Paul Klimo, MD, pediatric neurosurgeon, Semmes-Murphey Clinic
l Interesting Pediatric Neurology Case Vignettes – Robin Morgan, MD, assistant professor, Department of Pediatric Neurology, University of Tennessee Health Science Center
For more information about Mid-South Pediatric Neurology Update, visit www.methodistmd.org or call (901) 516-8933.
Le Bonheur offers hopes to tuberous sclerosis patient
Days before Hurricane Katrina hit South Louisiana,
10-year-old Ian Wright was hit with his first tonic clonic
seizure. Without a diagnosis, his parents tried desperately to
find a physician to help – but then they were evacuated to
Northern Louisiana and later relocated to Dallas.
Ian would endure three years of medication trials and
trips to the local neurologist and Epilepsy Monitoring Unit,
as his seizures were drug-resistant. In 2008, evaluation
disclosed he was positive for tuberous sclerosis complex
(TSC1) and Ian’s mom, Jody, started researching her options – including
magnetocephalography (MEG) testing and epilepsy surgery.
Ian’s pediatric neurologist, Steven
Sparagana, MD, director of the Tuberous Sclerosis
Complex clinic at Texas Scottish Rite Hospital for
Children, considered that MEG testing could help
identify the exact lesion causing Ian’s seizures.
“MEG is a great tool for these kids with
multiple brain lesions – it helps to establish
which one is causing the seizures, said Sparagana.
Sparagana then referred Ian to James Wheless,
MD, at Le Bonheur Children’s Hospital – one of
the few U.S. centers with MEG testing.
“It was really the expertise of
Dr. Wheless and his experience with
MEG that triggered the referral to
Le Bonheur,” said Sparagana.
“Dr. Wheless knows the technology,
he knows the value of testing. He’s
highly regarded in the field of
pediatric neurology and epilepsy.”
Ian underwent MEG testing
(Figure 1) in fall 2010, and was
admitted to Le Bonheur’s Epilepsy
Monitoring Unit (EMU) for additional
testing. Neurologists determined two
tubers seemed to be causing Ian’s
seizures, and agreed he would be a strong candidate for surgery.
Ian was readmitted to Le Bonheur Children’s in late
January 2011 for additional testing in the hospital’s EMU.
Subdural strips and a grid were placed using STEALTH
technology with co-registration of his MEG and MRI data by
neurosurgeon, Paul Klimo, MD, and subsequent testing
confirmed two tubers needed to be removed. All of this data
was combined with functional mapping studies and a plan
of surgery was outlined (Figure 2). Klimo removed the tubers
and grids, discharging Ian five days after surgery (Figure 3).
“Ian gets
stronger and stronger
every day and to say
we are thankful is
an understatement,”
said Jody Wright.
“In addition to our
regular neurologist,
Dr. Wheless and
Dr. Klimo have
provided hope
which we didn’t
have before going
to Le Bonheur. We
now are actually
talking about the
possibility of Ian
getting his driver’s
license and embrac-
ing the joy that
Ian has in looking
toward the future.”
Ian Wright
It all started with a warm welcome home. Faced with their son’s first brain surgery, Dallas couple Wally and Jody Wright were welcomed
into the FedExFamilyHouse, a 24-suite residence located less than a block from Le Bonheur Children’s Hospital. There, they would stay for free for nearly two weeks, close to their son, Ian.
The 25,000-square-foot home includes living and family rooms, four kitchens, dining facilities, indoor and outdoor recreational space and an office for families.
“The FedExFamilyHouse definitely embodies more than just a brick and mortar building – it is a haven for families needing peace and a place to call home when they are so far away from their own,” said Jody Wright. “When facing something like this, to have a place away from your home to call home provides comfort that is much needed.”
Before arriving in Memphis, the Wrights worried about paying for a hotel for their family for two weeks. Instead, they were offered respite and a genuine welcome to the house.
“Something as simple as making a homemade meal helps you feel that you are part of the healing process too,” Jody said. “This makes such a difference.”
To see more of the FedExFamilyHouse, visit www.lebonheur.org/fedexfamilyhouse.
Figure 1: Magnetocephalography (MEG) imaging was a useful diagnostic tool for
Ian Wright. Above, blue dots show Ian’s sensory cortex and the yellow
triangles show epilepsy dipoles.
Figure 2: Intracranial electrodes were implanted and functional mapping was conducted before surgeons
removed seizure-causing tubers.
Figure 3: Grey bars show areas that were surgically removed to relieve seizures.
Brain Waves is a quarterly publication of the Neuroscience Institute at Le Bonheur Children’s Medical Center. The institute is a nationally recognized center for evaluation and treatment of nervous system disorders in children and adolescents, ranging from birth defects and learning and behavioral disorders to brain tumors, epilepsy and traumatic injuries.
James W. Wheless, MD, Medical Director,Le Bonheur Comprehensive EpilepsyProgram and Neuroscience Institute
Paras Bhattarai, MD Frederick A. Boop, MDStephanie Einhaus, MDMasanori Igarashi, MDPaul Klimo, MDAmy McGregor, MDMark McManis, Ph.D.Kathryn McVicar, MDRobin L. Morgan, MDMichael S. Muhlbauer, MDF. Fred Perkins Jr., MDRobert Sanford, MDNamrata Shah, MD
Non-Profit Org.
US POSTAGEPAID
Memphis, TNPermit No. 3093
50 N. Dunlap StreetMemphis, Tennessee 38103
Neuroradiologist Choudhri brings expertise to Le Bonheur
Neuroradiologist Asim F.
Choudhri, MD, has joined
Le Bonheur’s Neuroscience
Institute.
Choudhri comes to Memphis
from Baltimore, where he
completed a fellowship in
neuroradiology at Johns Hopkins
University. Choudhri graduated
from the University of Tennessee
Health Science Center’s College of Medicine in 2004.
He has recently edited a text on spine imaging and
has a strong clinical research background. Choudhri is also
a faculty member of the American College of Radiology
review course in Neuroradiology, where he lectures on
topics including congenital brain malformations.
Harris Cohen, MD, chief of radiology at Le Bonheur
Children’s, said Choudhri’s addition complements new
imaging tools – like a 3T intraoperative MRI and 320 slide
Toshiba CT – that the hospital has added in recent months.
“Le Bonheur radiology and UT’s Department of
Radiology have sought radiologists with additional formal
training in neuroradiology to help bolster and lead our
continuing efforts in providing Le Bonheur patients with
state-of-the-art neurosurgical and neurologic diagnosis and
patient care,” Cohen said.
“The 3 Tesla intraoperative MR magnet coupled with
advanced 3D software tools allow rapid diagnostic information
available to the neurosurgeon while performing neurosur-
