Local epilepsy specialist fills niche for diagnosis, advanced care

Many patients misdiagnosed, over-treated, neurologist says

By Marissa Harshman, Columbian health reporter

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Epilepsy patients no longer need to cross the river to receive high-quality, specialized care.

Nor do they need to leave the county in order to receive continuous electroencephalogram (EEG) monitoring in a hospital setting.

Instead, patients need look no further than Legacy Medical Group’s neurology clinic in Salmon Creek and neurologist John Dempster.

Based on the response to Dempster’s arrival a year ago, epilepsy specialization was a definite gap in Clark County’s medical community. Within one month of opening the clinic, Dempster was booked one to two months out, he said.

“We’re growing fast because there’s such a backlog,” Dempster said.

While performing his clinical fellowship in epilepsy at Oregon Health & Science University in Portland, Dempster saw many Clark County residents forced to travel to Oregon to get advanced specialty care.

The population is largely underserved in the entire region, but particularly in Southwest Washington, Dempster said. Neurologists have worked in the county since the 1970s, but no one had specialized training in diagnosing and treating epilepsy, he said.

So once Dempster completed his fellowship, he opened his practice in Salmon Creek, giving Clark County its first and only epilepsy specialist.

Epilepsy is defined as more than two unprovoked, recurrent seizures. Seizures are the result of abnormal surges in electrical signals inside the brain. Typically, the trillion neurons in the brain fire chaotically. When the neurons become abnormally active, they fire rhythmically, causing the seizure, Dempster said.

Dempster specializes in clinical neurophysiology, or monitoring and reading EEGs. An EEG measures brain electrical activity and is often used to diagnose seizures and epilepsy.

Since arriving in Vancouver, Dempster said he’s noticed many patients who are misdiagnosed and over-treated for the condition. Neither problem is unique to Clark County, he said.

Neurologists typically read an EEG and look for abnormalities. But the equipment is sensitive, and sometimes something perfectly normal — such as a blip caused by coughing or sneezing — is interpreted as abnormal, he said.

“Sometimes, just based on that, people end up on lifetime seizure medicine,” Dempster said.

Patients also turn to Dempster for a review of their medication. Epilepsy drugs have harsh side effects, especially for a person who doesn’t benefit from the medication, Dempster said. Among the side effects are liver damage, depression, mood disorders, bone loss and memory loss, he said.

In addition to the office visits, Dempster also offers continuous EEG monitoring at Legacy Salmon Creek Medical Center.

When a patient has recurrent seizures and is not responding to medication or has a questionable diagnosis, Dempster can admit the patient to the hospital for up to a week of monitoring.

The patient is hooked up to an EEG as physicians try to provoke a seizure. When a seizure happens, the machine will give the physicians insight into what causes the patient’s seizures and show them exactly where in the brain it originates, Dempster said.

The small percentage of patients who need surgery to correct their epilepsy will still need to travel to Portland for the procedure, but, Dempster said, he can serve as a guide to help local residents through the process.

The entire region has seen the need for specialists such as Dempster grow as the population has grown, said Dr. Lewis Low, clinical vice president for Legacy.

“We’re just excited to be able to fill what we felt was a niche there,” Low said. “And provide a service to the community that wasn’t there.”

Marissa Harshman: http://twitter.com/col_health; http://facebook.com/reporterharshman; marissa.harshman@columbian.com; 360-735-4546.