Epilepsy Unit

Care

At the Epilepsy Unit we provide expert, specialised care for adults and children with epilepsy. With over 20 years of experience, we are recognised internationally as a reference centre. Our multidisciplinary team offers personalised and comprehensive attention to each patient. Across the Neurology Neurology and Paediatric Neurology Departments, more than 4,000 patients with epilepsy receive continuous follow-up at Vall d’Hebron.

We strive to make access to medical care as easy as possible, helping patients and their families avoid disruptions such as missed work or school days, and providing confidence and reassurance throughout their care.

Our professionals are highly trained in diagnosis and follow-up of complex epilepsies. Both the Adult and Paediatric Inpatient Areas have 24-hour video-EEG monitoring units, allowing early and precise diagnosis and the most appropriate treatment for each case. Continuous video-EEG monitoring also enables consideration of non-pharmacological treatments, such as surgery or neurostimulation.

We also have High-Resolution Epilepsy Clinics (CARE), offering rapid assessments to accelerate diagnosis and optimise treatment options in complex cases.

The Epilepsy Unit is a reference centre for epilepsy emergencies, providing 24-hour coverage by neurologists and epileptologists. Vall d’Hebron is one of the few hospitals in Spain with 24-hour access to EEG, CT perfusion and MRI. Continuous support from other departments such as Neurosurgery and Emergency Psychiatry ensures the highest quality of urgent care for people with epilepsy.

One of the most serious complications of epilepsy is status epilepticus, and Vall d’Hebron University Hospital is a leading centre in the diagnosis and treatment of this condition, contributing to the development of new international clinical guidelines.

We also run the Tele-Epilepsy Programme, a joint initiative with Arnau de Vilanova University Hospital, to provide remote epilepsy care. This programme promotes equality in access to specialised care while reducing unnecessary travel. The system is supported by a shared Neurosurgery Department serving both hospitals.

Teaching

Understanding epilepsy requires specialised training that promotes excellence in patient care.

All members of the Epilepsy Unit at Vall d’Hebron University Hospital are committed to maintaining and updating their clinical skills. They attend continuous training courses across different subspecialties to ensure that the whole team remains up to date.

Clinical objectives

1. Acquire advanced diagnostic and management skills for complex epilepsy in all age groups.
2. Interpret the diagnostic tests required for epilepsy control, including genetic testing, EEG, neuroimaging and pathology.
3. Interpret neuropsychological tests in epilepsy patients.
4. Diagnose sleep disorders in patients with epilepsy.
5. Manage psychiatric comorbidities in epilepsy.
6. Apply epilepsy knowledge to neuro-oncology.
7. Present cases at weekly EEG and MRI imaging meetings.

Research objectives

• Ability to carry out and lead clinical research through:
  • Clinical research approaches in epilepsy.
  • Translational research approaches in epilepsy.
• Conducting pharmacological clinical trials for patients with epilepsy.
  • Integration into the epilepsy clinical trials team.
  • Monitoring and follow-up of patients in clinical trials.
• Publishing in indexed journals.
• Presenting posters and communications at national and international conferences.
• Doctoral thesis.
• Participation in competitive (FIS) and non-competitive projects of the Epilepsy Group.

Programme

1. Management of hospitalised patients with an epilepsy diagnosis requiring prolonged video-EEG monitoring.
2. Management of critical situations related to epilepsy.
3. Participation in outpatient clinics.
4. Performing, reading and interpreting PSG/video-EEG studies in the Sleep Unit.
5. Performing, reading and interpreting EEGs in urgent cases.
6. Rotation in the Paediatric Electroencephalography Unit.
7. Participation in the monitoring of patients in clinical trials, including patient management tasks.
8. Weekly presentation of neuroimaging cases.
9. Weekly presentation of psychiatric cases.
10. Presentation of neurosurgical cases.
11. Management of patients with brain tumours.
12. Presentation of genetic epilepsy cases.

Residents training

Professionals in the Epilepsy Unit actively participate in the training of Neurology residents (MIR) at Vall d’Hebron University Hospital. The four annual neurology residents complete a minimum two-month rotation in the Unit, in addition to continuous exposure to epilepsy emergencies throughout their specialisation. This consolidated training is coordinated through the Teaching Subcommittee of Vall d’Hebron University Hospital. We also train residents from other specialties such as neurosurgery, psychiatry and neurophysiology during their residency. In addition, we host national and international residents and neurologists who wish to complete rotations or training stays in our unit.

Research

Finding new treatment alternatives for patients who do not respond to current drugs is the top priority within our unit. In epilepsy clinical trials, we are leaders in most of the molecules currently under development worldwide. We have been the top global recruiter in trials for recently marketed drugs such as lacosamide, brivaracetam, cenobamate and cannabidiol, among others. This enables us to offer our patients the most advanced therapies available.

At the same time, the Epilepsy Unit carries out cutting-edge research aimed at improving care for patients and their families. We are specifically focused on identifying biomarkers and new therapeutic targets that bring us closer to curing the disease.

The main research lines in adult epilepsy include:

• Status epilepticus and epilepsy emergencies: early diagnosis, prognosis and social cost of critical epilepsy. Epileptogenesis associated with status epilepticus.
• Drug-resistant epilepsy and prognosis – mortality: behavioural disorders and functional impairment. Psychological, social and family impact of epilepsy.
• Epileptogenesis in cerebrovascular disease: stroke mechanisms that promote epilepsy development.
• Neuroimaging studies and cognitive assessment in epilepsy. Epilepsy as a tauopathy.
• Epilepsy and its association with sleep disorders.

In the field of paediatric neurology, which has its own research group, the number of clinical trials, publications and participation in international research consortia (Cost-Actions, SYNAPs network, Solve-RD and other European projects) have made this section a reference in research and innovation, mainly related to rare epilepsies, for example:

• Application of NGS techniques to identify and characterise new genetic variants responsible for these diseases.
• Establishing correlations between genetic variants and clinical forms of the disease.
• Characterisation of the functional impact of the variants.

The results of our research, with more than 30 indexed scientific publications annually over the past 20 years, confirm the quality of the research conducted in our unit. Moreover, among competitive projects, we are currently researchers in several FIS projects funded by the Instituto de Salud Carlos III, including the evaluation of the causality of NGS candidate genes in epileptic and developmental encephalopathies, validation of the Status Code scale, and the identification of biomarkers predicting status epilepticus. We also collaborate on competitive projects investigating epilepsy biomarkers. We are developing our own research line studying cognitive impairment in patients with epilepsy of all ages.