Wellstar Kennestone Hospital Performs First Neurovascular Robotic Procedure

Having or witnessing a seizure can be frightening. But clinicians have made remarkable advances in diagnosing the causes and preventing future seizures with medications and surgery.

“Seizures often seem scarier to bystanders than to patients,” said Dr. Thomas Holmes, a Wellstar neurologist. “Most patients don’t even remember them.”

Epilepsy is more common than many realize—about 1 in 26 people will be diagnosed in their lifetime. On WSB’s The Weekly Check-Up, Dr. Holmes explained how epilepsy is diagnosed, why not all seizures mean epilepsy and what treatments are available.

As director of neurodiagnostics at Wellstar, Dr. Holmes helped Wellstar Kennestone Regional Medical Center earn Level 3 Adult Epilepsy Center accreditation, recognizing its advanced care for patients with hard-to-treat seizures.

Diagnosing epilepsy

According to Dr. Holmes, a seizure happens when there's an “abnormal firing of neurons in the brain.” This electrical disturbance can cause a range of symptoms—some more visible than others. A person having a seizure may briefly lose consciousness, and other signs can include:

• Trouble breathing or temporarily stopping breathing
• Sudden falls without warning
• Jerking movements or a sudden loss of muscle control
• Loss of bladder or bowel control
• Not responding to sounds or voices for a few moments
• Staring spells, sometimes with rapid blinking

It’s important to know that not all seizures are caused by epilepsy. Other conditions like stroke, brain injuries, infections or tumors can also trigger them. That’s why gathering details from someone who witnessed the seizure—like a family member—can be helpful for doctors trying to make an accurate diagnosis.

When someone experiences a seizure, the first step is usually brain imaging. An MRI is often ordered to look for structural causes, and an EEG, which records the brain’s electrical activity, can help detect abnormal patterns. In some cases, patients may be asked to wear a portable EEG at home for several days to capture activity that doesn’t happen regularly. Both MRIs and EEGs are safe and painless.

For more advanced monitoring, Wellstar offers inpatient epilepsy monitoring units (EMUs) at Wellstar Kennestone, Wellstar MCG Health and Wellstar North Fulton Medical Centers. These specialized units provide around-the-clock observation and are among the few in Georgia offering this level of epilepsy care.

Medications and surgery for seizures and epilepsy

For most people with epilepsy, medication is the first and most effective treatment option. How long someone needs to stay on medication depends on several factors, including what’s causing the seizures and what clinicians find during ongoing monitoring.

Sometimes a seizure is triggered by a specific event, like a head injury. In those cases, Dr. Holmes explained, long-term medication may not be necessary. But if tests reveal a structural issue in the brain—like an area of damage—it usually means a higher risk of future seizures and longer-term treatment is often recommended.

“You don’t necessarily need to be on medication for life, even if you have epilepsy,” said Dr. Holmes. Patients are regularly monitored, treatment plans are highly personalized and care plans are revisited to ensure the best outcomes possible.

“If someone has been seizure-free for two to three years, has a normal EEG and no visible brain lesion, we’ll often discuss tapering off medication if the patient is open to it,” he said.

Some people may struggle with seizure control despite medication. About 10% of patients don’t respond well to drugs—but there are additional treatments available.

Wellstar’s EMUs can help determine where in the brain seizures are starting. In some cases, surgery to remove a small area of brain tissue can significantly reduce or even stop seizures. According to Dr. Holmes, this approach is successful in nearly 70% of cases.

Other advanced options include laser surgery or a responsive neurostimulation—when a small device is implanted in the brain to detect abnormal activity and deliver a pulse to stop a seizure before it starts.

Looking ahead, Dr. Holmes is optimistic. “There are going to be many options that are not drug-related,” he said. “Less invasive procedures are on the rise, and we’re learning more about the genetic causes of epilepsy—especially in children. Research and clinical trials may even lead us to gene therapies in the near future.”

Epilepsy care is evolving rapidly, and for many patients, that means more control, fewer side effects, and real hope for the future.

Epilepsy and Seizures Program at Wellstar

Our Epilepsy and Seizures Program is one of only a few such programs in Georgia. It provides comprehensive care to help children and adults manage seizures. The program also offers a streamlined pathway to determine if a patient is a candidate for advanced treatments, including minimally invasive surgery and deep brain stimulation.

Wellstar Children's Hospital of Georgia and Wellstar MCG Health in Augusta are Level 4 Comprehensive Epilepsy Centers, the highest designation by the National Association of Epilepsy Centers. Wellstar Kennestone is a Level 3 Adult Epilepsy Center.

Learn more about the Epilepsy and Seizures Program and Wellstar providers.

Marietta, GA— Wellstar Kennestone Regional Medical Center has achieved a rare milestone in cardiac care, earning the highest possible rating—three stars—in four categories evaluated by the Society of Thoracic Surgeons (STS). This distinction places Wellstar Kennestone among the elite cardiac surgery programs in the U.S. and Canada.

The STS Star rating system is one of the most rigorous, verified and respected measures of quality in healthcare, based entirely on objective patient outcomes and implemented medical care processes. The latest analysis evaluates performance during a three-year period, from January 2022 to December 2024. Wellstar Kennestone earned the coveted three-star rating in the following key areas: isolated coronary artery bypass grafting (CABG, or open-heart surgery), aortic valve replacement (AVR), AVR + CABG, and multiprocedural cardiothoracic surgeries.

“This extraordinary recognition reflects the world-class quality of care offered by Wellstar,” said Lorrie Liang, senior vice president and hospital president of Wellstar Kennestone and Wellstar Windy Hill. “To achieve this gold standard, a health system must demonstrate both clinical excellence and rigorous standards for follow-up care. At Wellstar, we provide all of this, along with a warm, people-centered experience. It’s what we call ‘PeopleCare.’”

Previously, Wellstar Kennestone had earned three-star ratings in two categories. This latest achievement marks a significant advancement, solidifying its position as a national leader in cardiothoracic surgery.

“This new accomplishment speaks volumes about the skill, precision, and teamwork of our cardiothoracic team,” said Dr. Richard Myung, medical director of cardiothoracic surgery at Wellstar Kennestone. “We’re proud to deliver exceptional outcomes for patients from across the Southeast who have some of the most complex heart conditions.”

“This amazing recognition is about the great lengths we go to care for our patients, and why people travel from across the region to receive their care at Kennestone,” added Karrie Davis, Director of Wellstar Cardiothoracic Surgery Services and the Structural Heart and Valve Program. “We care for every patient like they’re a family member or close friend. That’s why we hold ourselves to the highest standards.”

STS ratings reflect not only surgical excellence, but also the quality of care patients receive in the critical 30-day period following surgery. These results highlight the importance of a multidisciplinary approach—one that includes surgeons, anesthesiologists, perfusionists, nurses, cardiologists, respiratory therapists, rehabilitation specialists, critical care specialists, hospitalists, advanced practice providers and many others.

“This achievement is a testament to the entire care continuum,” said Cindy Holcomb, Wellstar executive director of cardiovascular nursing at Wellstar Kennestone. “From the operating room to recovery and rehabilitation, every team member plays a vital role in delivering outstanding outcomes.”

With a team of more than 110 cardiologists and cardiovascular surgeons, the Wellstar Center for Cardiovascular Care is home to one of Georgia’s most comprehensive cardiovascular programs. Its flagship, Wellstar Kennestone, was the first hospital in the state to earn the prestigious Comprehensive Cardiac Care Certification—the highest distinction awarded by the Joint Commission and the American Heart Association.

For more information about Heart Care at Wellstar, visit wellstar.org/heartcare.

This article was originally published on Atlanta Business Chronicle on May 19, 2023.

Stroke is the fifth leading cause of death in the United States. The Georgia Department of Public Health reports the state had the 12th highest stroke death rate in the country. Georgia is also part of the “stroke belt,” an area of the southeastern United States with stroke death rates 30% higher than the rest of the nation.

As the leading — but preventable — cause of disability, stroke can happen at any age.

Stroke is a medical emergency, meaning the blood flow to an area of the brain is cut off, depriving brain tissue of oxygen and nutrients. When this happens, brain cells start to die and abilities controlled by that area of the brain, such as speech or muscle control, are lost.

New drugs and new advanced treatments — such as the Tigertriever and Artemis — are helping reduce the death and disability impact of stroke, as well as comprehensive care programs and innovative hospital partnerships that expand stroke services into rural areas.

Physicians from Wellstar Health System and the CEO of a hospital in northeast Georgia joined Atlanta Business Chronicle to discuss stroke prevention and the future of stroke care.

Panelists & moderator

• Dr. Rishi Gupta, Endovascular Neurologist and Co-Medical Director of Neuro Care
• Dr. Ashis Tayal, Vascular Neurologist, Wellstar, Director of Neuro Care Network
• Van Loskoski, CEO, Stephens County Hospital
• David Rubinger, Market President & Publisher, Atlanta Business Chronicle; Moderator

What is stroke, screening and secondary prevention

David Rubinger: Dr. Tayal, set the stage for us about the definition of stroke.

Dr. Ashis Tayal: A stroke is a sudden injury of the brain due to blockage or rupture of an artery in the brain. Injuries to the brain and disability can vary significantly.

The most common, ischemic stroke injury, is due to obstruction of an artery that causes a loss of blood flow to a critical part of the brain which damages the brain rapidly.

The other type of stroke is hemorrhagic stroke, where there’s a rupture of an artery, bleeding into the brain, or the surfaces of the brain, and that is called an intracerebral hemorrhage or a subarachnoid hemorrhage.

Rubinger: I think Americans have become a little better educated as to who’s at risk for stroke, but why don’t you walk us through that. Who would be a potential stroke candidate?

Tayal: High blood pressure, or hypertension, is the most common risk factor for both ischemic and hemorrhagic strokes. High blood pressure is an extremely common but controllable condition. Almost 80% of people have hypertension as they’re getting older.

Other risk factors include diabetes associated with elevated blood sugars causing accelerated blockage of arteries and high cholesterol, which can be related to diet and genetics.

Atrial fibrillation, a common heart arrhythmia that occurs as people get older, also places people at risk for the most severe and disabling types of strokes. And plaque buildup in specific arteries of the neck and brain also leads to an increased risk of stroke.

Smoking is another risk factor. Many adults still smoke despite a lot of progress in stroke treatment, and smoking puts people at risk for different types of stroke.

Rubinger: What about atmospheric things like stress and other areas like that? How does that play into it? Or do those things manifest themselves because of the other underlying physical conditions?

Tayal: I don’t view stress, in and of itself, as a risk factor for stroke. I think that’s more related to people’s environments and their own personalities and how they respond to stress. I do think people who are under undue stress can have poor lifestyle habits, and those poor lifestyle habits, whether poor eating habits, smoking, weight gain or lack of exercise, can lead to conditions that increase the risk for stroke.

Rubinger: So how is the healthcare system doing treating strokes? Do you believe that what’s going on at the primary care provider’s office is helping or do we have a way to go?

Tayal: In the United States, preventive care has improved the treatment of risk factors that lead to stroke, but communities must maintain routine checkups as many of the risk factors are silent.

There are improved treatments for hypertension, more aggressive treatment for diabetes, and more efforts at smoking cessation. Just the fact that we treat hypertension better than we did a generation ago has had a great impact on lowering the prevalence of stroke.

That being said, some of the most exciting work on stroke has often been done in the area of acute treatment of stroke with clot-busting drugs, catheter-based treatments and medications to protect the brain during an acute injury.

Rubinger: Has pharmacology gotten better in terms of the hypertension medicines that are out there? Have anti-cholesterol medicines improved in recent years?

Tayal: In the past, healthcare providers were often undertreating people with hyperlipidemia — high cholesterol — and not fully appreciating the benefits of significant reductions in cholesterol levels. For example, we’ve learned that driving cholesterol down into much lower ranges under 55 mg/dL can benefit our patients who have vascular disease as a cause for their stroke.

In the fight against high cholesterol, newer medications that prevent the absorption of cholesterol are now available. Recent developments have led to the discovery of a new underutilized class of drugs called PCSK-9 inhibitors that are highly effective.