Good Morning Chairman Michaud, Ranking Member Miller and Members of the Subcommittee. I want to thank you for holding this hearing on H.R. 2818, the VA Epilepsy Centers of Excellence Act.

The VA Epilepsy Centers of Excellence Act, which I introduced on June 21, 2007, will create at least 6 VA Epilepsy Centers of Excellence within the VA Health Care system. A companion bill carried by Senator Patty Murray passed the Senate VA Committee on December 12, 2007. These Centers of Excellence will care for all veterans’ experiencing seizures and especially those we predict will develop epilepsy as a result of suffering a Traumatic Brain Injury (TBI) while serving in Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF).

Epilepsy is defined as two or more seizures. During Vietnam, a number of men and women returned home with head wounds and head injuries. Of those who came home with these types of injuries, some 53% developed epilepsy within 15 years. 15% of those who developed Epilepsy did so five or more years after their combat injury.

Last year, I met with Dr. John Booss, the former Director of Neurology for the VA. He advised me that in 1972, the VA responded to the rise in veterans returning with seizures by creating VA Health Centers around the nation that specialized in the treatment and research of epilepsy. The VA Centers partnered with medical schools to assist it in treating the veterans with seizures and building a body of knowledge concerning epilepsy. However, sometime in the 1980’s or early 1990’s the increase in veterans developing epilepsy subsided, funding dissipated and the Centers were curtailed. At this time the VA operates seven Epilepsy Monitoring sites. These sites lack the resources and capacity to care for our current veterans with epilepsy.

Dr. Booss and a number of organizations such as the American Academy of Neurology, The Epilepsy Foundation of America, the Brain Injury Association, and the Citizens United for Research in Epilepsy (CURE) have highlighted the need to rebuild the Epilepsy Centers of Excellence for the many men and women returning from the middle east with head wounds and brain injuries. Your committee is only too aware of the injuries suffered by our service men and women in Iraq and Afghanistan. It is estimated that today some 89,000 veterans have epilepsy of which 42% of that number is service connected. If our country’s experience in Vietnam is any indication of what to expect in the future the number of veterans with epilepsy is bound to rise.

[As an example, after I introduced this Bill, I was contacted by one of my constituents, Naval Reserve Petty Officer Brian Johnson. He suffered a TBI while assigned to Navy Mobile Construction Battalion 7 just outside of Fallujah, Iraq. On November 7, 2004, his position came under fire and he sustained a brain injury when he was blown against a wall when two mortars exploded nearby. After returning home he resumed his small plumbing business, but eventually lost it due to the incidence of seizures. Petty Officer Johnson’s story is just one of many emerging from the experiences our service men and women are having after returning home.]

HR 2818 establishes a process where VA Medical Centers partner with medical schools across the country to compete for the designation of a VA Epilepsy Center of Excellence. 6 of these Centers would be selected by the VA and would be disbursed across the country. The VA’s telemedicine capacity would also be expanded to track the neurological diagnostic tests of our rural veterans. It is anticipated that each of these centers would cost about $1 million for the first 4 years.

These Centers will develop and administer treatments and possibly cures for our veterans that will allow them to live the best lives possible. Moreover, the body of knowledge developed through the research conducted by the VA and the medical schools will help our society as a whole. (And as full disclosure I should mention that I have a daughter with epilepsy who might benefit by the body of knowledge generated through the research and treatment of our veterans with epilepsy.) 

I want to thank the Disabled American Veterans, the Paralyzed Veterans, the Blinded Veterans, and the Vietnam Veterans of America and the other organizations I mentioned earlier for their support of this bill. Chairman Michaud, Ranking Member Miller and Members of the Subcommittee, thank you again for inviting me to testify. I look forward to answering any questions you may have.

Studies referenced:

Epilepsy after penetrating head injury. I. Clinical correlates: A report of the Vietnam Head Injury Study. Andres M. Salazar, Brahman Jabbari, Stephen C. Vance, Jordan Grafman, Dina Amin, and J.D. Dillion. Neurology 1985; 35; 1406