Internal Medicine for Epilepsy and Sleep Disorders

The Epilepsy and Sleep Disorders Center of the Second Hospital of Harbin Medical University was established in 2013. It is the first center in Heilongjiang Province integrating the diagnosis and treatment of epilepsy and sleep disorders, and also the first sleep-disorder diagnosis and treatment center in the province. The Epilepsy and Sleep Disorders Center has 24 medical and nursing staff members, including 5 physicians and 19 nurses. Among them are 1 doctoral postgraduate supervisor and 2 master’s postgraduate supervisors. There are 2 chief physicians/professors. The center has 1 postdoctoral fellow, 2 doctors with doctoral degrees, and 3 doctoral students currently enrolled. The center has more than 10 imported digital video electroencephalography and polysomnography machines, including 64-channel and 32-channel systems; it has an independent sleep-related scale assessment room, an EEG and sleep-monitoring center control room, a cognitive behavioral therapy room, a neuromodulation room, and physicians’ workstations. It is an epilepsy and sleep-disorder diagnosis and treatment center that ranks among the largest in our province.

To continuously promote exchange and communication among epilepsy and sleep-medicine professionals in our province and advance the development of epilepsy and sleep medicine in the province, with this center as the lead institution, the following professional academic organizations have been established successively: the “Extreme Environments and Sleep Professional Committee of the Chinese Sleep Research Society,” the “Aging and Biological Rhythms of Sleep and Wakefulness in Older Adults Group of the Chinese Association of Gerontology and Geriatrics,” the “Heilongjiang Province Epilepsy and Sleep Disorders Specialist Alliance,” the “Heilongjiang Sleep Society,” the “Epilepsy Professional Committee of the Heilongjiang Medical Doctors Association,” and the “Epilepsy and Sleep Disorders Professional Committee of the Heilongjiang Cerebrovascular Disease Society,” among others. Various forms of exchange activities and academic lectures in the fields of epilepsy and sleep research are held regularly. The center has carried out substantial work in training specialist physicians for our province and even the whole country, and enjoys a high level of recognition and influence within the profession. At the same time, the center is a council member institution of the Chinese Association Against Epilepsy and a council member institution of the Chinese Sleep Research Society; it is one of the first member institutions of the Chinese Narcolepsy Collaboration Group and a co-leading institution of the Narcolepsy and Hypersomnia Diagnosis and Treatment Alliance of the three northeastern provinces and Inner Mongolia. The center’s physicians hold important academic positions in multiple national professional committees, such as chairpersons and vice chairpersons of the Extreme Environments and Sleep Professional Committee of the Chinese Sleep Research Society; vice chairpersons and standing committee members of the inaugural committee of the Sleep Medicine Branch of the Chinese Stroke Society; members of the Epilepsy Group of the Neurology Professional Committee of the Chinese Medical Association; members of the Behavior and Health Promotion Group of the Behavioral Medicine Branch of the Chinese Society of Behavioral Medicine; standing committee members of the Sleep Disorders Professional Committee of the Chinese Sleep Research Society; members of the Sleep Society Branch of the China Health Care Association; members of the Youth Committee of the Chinese Association Against Epilepsy; members of the Drug Treatment Professional Committee of the Chinese Association Against Epilepsy; members of the Precision Medicine and Adverse Drug Reaction Monitoring Professional Committee of the Chinese Association Against Epilepsy; members of the Epilepsy Professional Committee of the Neurology Branch of the Chinese Medical Doctors Association; and members of the Sleep Group of the Neurology Branch of the Chinese Medical Doctors Association, among others.

All physicians at the center are qualified to provide standardized diagnosis and treatment for epilepsy and sleep-disorder diseases. All passed the national intermediate-level EEG proficiency examination with excellent results and hold national Level II psychological counselor qualifications, forming a professional and standardized subspecialty medical team for epilepsy and sleep disorders. The center has advanced medical equipment, complete and well-equipped ward facilities, and a superior hardware and software environment. It provides standardized diagnosis and treatment for various types of epilepsy and sleep-disorder diseases, with standardized diagnostic methods and procedures, and strives to provide patients with high-quality medical services.

For patients with epilepsy, video EEG monitoring can be performed, and antiseizure medication treatment can be administered and adjusted in a standardized manner. For drug-resistant epilepsy, the center collaborates with functional neurosurgery, radiology, pediatrics, pathology, and other departments for presurgical evaluation; stereoelectroencephalography monitoring (SEEG); vagus nerve stimulation (VNS); deep brain stimulation (DBS); preoperative and postoperative medication adjustment; and ketogenic diet treatment for drug-resistant epilepsy. A variety of specialized tests are conducted for etiological screening of epilepsy, including genetic diagnosis (including testing for pathogenic genes and pharmacogenes), antibody testing related to autoimmune encephalitis and paraneoplastic syndromes, and others. The center can perform routine video EEG examinations and long-term video EEG monitoring, including 2-hour, 4-hour, 8-hour, and 24-hour video EEG monitoring. Bedside EEG monitoring can be performed for critically ill patients; for patients before and after arousal and critically ill patients, EEG activity can be monitored to assist in determining brain death.

For all types of sleep disorders, including insomnia, sleep apnea-hypopnea syndrome, narcolepsy, restless legs syndrome, sleepwalking, somniloquy, bruxism, catathrenia, rapid eye movement sleep behavior disorder, periodic limb movement disorder, and other diseases, standardized comprehensive examinations and diagnosis and treatment are provided. The examinations conducted include: 1) overnight polysomnography; 2) portable sleep-breathing monitoring; 3) multiple sleep latency tests; 4) maintenance of wakefulness test; 5) standardized assessment using various neuropsychological and sleep scales; 6) noninvasive positive-pressure ventilator titration, etc. For patients with insomnia, the center has routinely conducted repetitive transcranial magnetic stimulation and cognitive behavioral therapy, both of which are nonpharmacological therapies. They help patients reduce and discontinue sedative-hypnotic medications used to aid sleep at an early date, providing patients with insomnia with more and better options, and have received widespread praise from patients. For patients with sleep apnea syndrome, portable sleep-breathing monitoring can be performed, which patients can complete at home without hospitalization. For patients with moderate-to-severe sleep apnea-hypopnea, the center can perform noninvasive positive-pressure ventilator titration and trial use, helping patients who snore enjoy stable, well-oxygenated sleep.

The Epilepsy and Sleep Disorders Internal Medicine Department has established a specialized outpatient clinic to diagnose and provide standardized treatment for patients with epilepsy and sleep disorders, as well as conduct regular follow-up. According to the specific characteristics of each patient’s condition, individualized and targeted diagnosis and treatment plans are formulated; disease-related knowledge is disseminated; and rational advice is provided regarding study, work, life, marriage, and childbearing. This ensures that the patient’s diagnosis, medication selection, medication dosage, treatment efficacy, adverse effects, comorbidities, intellectual development, mental and behavioral status, psychological state, and other aspects remain under the physician’s close observation and guidance. Since the department was established, it has actively conducted patient health education, public-interest lectures, and free clinics; it has successfully held several free-clinic and public-interest activities and established a patient support group for patients with epilepsy and sleep disorders (the group QR code can be found in the department images), facilitating communication between patients and physicians, providing patients with scientific and effective disease management and daily-life guidance, helping them overcome their diseases as soon as possible, regain confidence, return to society, and bring hope to more patients and families.