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Highlights
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 Jackie Reszetar
In 1994, Jackie Reszetar experienced her first tonic-clonic (formerly known as “grand mal”) seizure while serving as an Environmental Science Officer Engineer in the Army. While Reszetar continued to have seizures that would impact her life and profession, her healthcare providers were not able to explain much about her epilepsy and many of the anti-seizure medications she was prescribed caused challenging side effects.
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Reszetar was able to find care and answers at the VA Epilepsy Center of Excellence (ECoE) at the Baltimore VA Medical Center in Baltimore, MD. By working with Dr. Omar Iqbal Khan, Site Director of Baltimore ECoE, and his staff, they were able to diagnose Reszetar with occipital lobe epilepsy. “Dr. Khan and the Baltimore ECoE are like no other,” said Reszetar.
The team made the discovery that Reszetar could not have surgery because it could potentially render her blind. Instead, the team has helped Reszetar manage her epilepsy through self-management and minimal medication. They also worked with her to manage her aura, which can include flashes of light, blind spots or tingling in the hands or face. An aura is what some people use to describe the sensation or feeling they get before they have a tonic-clonic seizure.
“It is nice to know they are on my side, and Dr. Khan was always there for me. I think it is part of the aura management, just knowing that they understand me and other patients. We worked together to get the results,” said Reszetar.
Since working with Dr. Khan and his team, Reszetar has been able to give back to the epilepsy community by getting involved in leadership and advocacy roles. She is an advocate for the Anita Kaufmann Foundation and is participating in a General Dynamics consumer research study as a consumer advocate. There she helps monitor grant projects and provides consumer feedback on the impacts of epilepsy-related grant projects.
Reszetar also serves as the Northeast Region VA Veteran Representative for the ECoE. Reszetar says that she finds all of these experiences very rewarding. “I just want to help others, and then we have to get other Veterans to speak about the benefits of the ECoE and the impact that it can have,” said Reszetar.
To help gain her confidence and learn skills to manage her symptoms, Reszetar participated in the Behavioral/Cognitive Rehabilitation and Intervention for Seizures (BRAINS) program. BRAINS is an eight-week program that consists of teleconferences that teach Veterans self-management tools to work and live with epilepsy.
Reszetar is excited to see VA’s ECoE expand, and for more Veterans to know about it. “The ECoE team started understanding me and what I was going through. The whole thing has just been an absolute blessing and change to my life,” said Reszetar.
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With 2.8 million Veterans residing in rural communities and enrolled in VA care, VA’s Neurology Program needed a way to reach this population effectively. To address this challenge, VA established the National Tele-Neurology Program (NTNP) in 2020.
Through VA’s NTNP, outpatient neurological care is provided to rural Veterans using telehealth technology. Visits are conducted by secure video conferencing, both at VA facilities and in Veterans’ homes. Neurologists' recommendations are shared directly with referring clinicians to provide the best coordinated neurological care to Veterans. NTNP is funded by the Office of Rural Health (ORH) and partners with 16 VA sites across the country. Working together, VA’s neurology experts deliver services in the fields of headache, dementia, stroke, epilepsy, movement disorders, multiple sclerosis and neuromuscular disorders to these sites.
VA’s NTNP provides high-quality neurological care for Veterans by using the following innovative technology:
Remote Patient Monitoring: Wearable mobile devices that allow patients with neurologic disorders to collect and send health data to providers for managing care.
Annie Headache Health Protocol: A text messaging service that empowers Veterans to take an active role in their health care by sending various automated questions, reminders, education tips and resources for tracking headache data. For more information about the Annie Headache Health Protocol, click the here.
EConsult: A form-based online consultation and triage platform that collects medical data or administrative requests to direct patient information to providers in a timely fashion.
My VA Images: A mobile app that enables Veterans to send secure photos and videos to their providers so they can receive expert health care without visiting a VA facility.
Watch this video to learn more about VA’s National Tele-Neurology Program!
Improving Epilepsy Testing Through Tele-EEG
VA’s National Tele-EEG and Epilepsy Program (NTEEG-EP) works in concert with the National VA Epilepsy Centers of Excellence (ECoE) to provide high-quality epilepsy care and remote Tele-electroencephalography (EEG) for Veterans with epilepsy and seizure disorders in rural and underserved locations. Tele-EEG uses state-of-the-art equipment to review EEG data—a recording of electrical activity in the brain using small electrodes placed on the scalp—remotely across VA facilities nationwide. Through Tele-EEG, Veterans can undergo brain activity monitoring from their local VA clinic, hospital or home. This expedites EEG testing and reduces the need to travel long distances to a specialized hospital or clinic.
Tele-EEG launched in 2011 serving 10 locations. In 2022, the program received funding in the President's budget and has since expanded to serve 23 VA hospitals and clinics. The program currently has 10 more locations underway, including collaborations with military hospitals. Looking forward, the program aims to expand Tele-EEG’s footprint further to more than 30 locations by 2025.
To find an Epilepsy Center of Excellence site near you, click here.
VA’s Telestroke Program is saving Veterans’ lives
Recognizing stroke symptoms and acting fast saves lives. Stroke is the 5th leading cause of death, but few people know the signs. So, use the acronym BEFAST to remember the warning signs and to know what to do if someone near you is experiencing a stroke:
B – Balance: Watch for sudden loss of balance
E – Eyes Problem: Check for sudden loss of vision or double vision
F – Face: Look for sudden facial droop
A – Arm Weakness: Check for sudden weakness in one arm or leg
S – Speech: Listen for sudden slurred speech or difficulty speaking
T – Time: Call 9-1-1 immediately
Click here to learn more about the warning signs and the technology VA’s National Telestroke Program uses for improving patient care.
If you are a Veteran suffering from:
- Headaches
- Tremor
- Unexplained weakness
- Numbness
- Problems with memory loss
- Other neurological problems
Reach out to your care team for more information!
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Roy Earl Swearingen, a Marine Corps Veteran, got an infusion of hope when he became the second patient in Texas, and the first Veteran in the country, to receive a groundbreaking drug aimed at slowing the progression of amyotrophic lateral sclerosis (ALS).
“I am hoping for the best and grateful to be able to get this new medication,” Swearingen said. “My VA doctors told me about the research into this drug and when it became FDA-approved they were right on top of getting me started on it as soon as possible. I can’t thank them enough.”
"Tofersen is used for the treatment of a rare form of ALS in adults who have a mutation in the superoxide dismutase 1 (SOD1) gene," said Dr. James Orengo MD Ph.D., Director of the Houston VA ALS Center.
“About 1-2 percent of ALS patients have the SOD1 gene, making them eligible for this new medication,” Orengo said. “This is the first approved treatment to target a genetic cause of ALS and we are thrilled to offer it to Mr. Swearingen and other eligible Veterans.”
Swearingen was diagnosed with ALS a little over a year ago and according to his wife, Sally, the availability of a new medication means the world to his entire family. “We are very hopeful that we will see an improvement or at least a slowing of the ALS symptoms as a result of the new medication,” she said. “We have a three-year-old son who wants to know his father.”
ALS, also known as Lou Gehrig’s disease, is a fatal neurological disease that causes degeneration of nerve cells in the brain and spinal cord leading to muscle weakness, atrophy and loss of function. ALS ultimately robs a person of the ability to walk, talk, eat and breathe.
The ALS Association says over 5,000 people are diagnosed with the disease every year and most people that develop ALS are between the ages of 40 to 70 years old. Early diagnosis of ALS is very important, especially when it comes to Veterans, Orengo said.
“Although there currently is no cure, early detection and expert clinical care can provide optimal quality of life through a total body and holistic management of symptoms,” Orengo said. “Research tells us that Veterans are at greater risk of being diagnosed with ALS than those with no history of military service. At VA, we are determined to make sure our Veterans have access to the latest available medications and treatments of ALS symptoms.”
To read the full article, click here.
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Veterans with Parkinson’s Disease (PD) or Parkinsonism who were exposed to herbicides, chemicals or contaminants during their service may be eligible for benefits and are strongly encouraged to apply through VA's benefits portal. As VA continues to introduce new legislation, we understand as a Veteran it can raise numerous questions. To help navigate the path forward, VA has gathered the following frequently asked questions (FAQs).
What exposures are associated with PD?
- Exposure to herbicides such as Agent Orange
- Exposure to certain chemicals, such as the solvents that contaminated water at Camp Lejeune
- Traumatic brain injury: The Gulf War and Health Volume 7 report found a positive association between moderate or severe traumatic brain injury and Parkinsonism
Who may be eligible to receive benefits for PD?
- PD and Vietnam Service: In 2010, VA added PD to the list of 14 conditions presumed to be service connected for Veterans with military exposure to Agent Orange and other herbicides in Vietnam and other areas. In 2021, Parkinsonism was added to the list of presumptive service-connected conditions associated with Agent Orange.
- Camp Lejeune: VA added PD to the list of conditions with a presumption of service connection to service personnel at Camp Lejeune for no less than 30 days between August 1, 1953 and Dec. 31, 1987. The Risk of Parkinson's Disease Among Service Members at Marine Corps Base Camp Lejeune study reaffirms VA’s 2017 policy decision to establish PD as a presumptive condition for service connection.
- Republic of Vietnam: Presumed exposure on land in the Republic of Vietnam, aboard a U.S. military vessel operating on the inland waterways of Vietnam, or on a vessel operating not more than 12 miles seaward from the demarcation line of the waters of Vietnam and Cambodia as defined by the Blue Water Navy Vietnam Veteran Act of 2019 between January 9, 1962 and May 7, 1975.
- Korean Demilitarized Zone: Veterans who served in or near the Korean Demilitarized Zone between September 1, 1967 and August 31, 1971.
- Thailand Military Bases: VA considers, on a case-by-case basis, disability benefits claims based on exposure to herbicides on a U.S. military base in Thailand or Royal Thai Air Force base between January 9, 1962 and June 30, 1976.
- C-123 Aircraft: VA expanded disability benefits to Air Force and Air Force reserve personnel who, between 1969 and 1986, regularly operated, maintained or served onboard the same C-123 aircraft used to spray herbicides during the Vietnam era.
- Herbicide Tests and Storage Outside Vietnam: Agent Orange and other herbicides used in Vietnam were tested or stored elsewhere, including military installations within and outside the U.S.
- The PACT Act of 2022: Added several locations to the areas eligible for Agent Orange presumptions, including:
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Republic of Vietnam – January 9, 1962 - May 7, 1975
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Thailand – Any U.S. or Royal Thai base January 9, 1962 - June 30, 1976
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Guam or American Samoa (or in their territorial waters) – January 9, 1962 - July 31, 1980
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Laos – December 1, 1965 - September 30, 1969
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Cambodia at Mimot or Krek, Kampong Cham Province – April 16, 1969 - April 30, 1969
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Johnston Atoll – January 1, 1972 - September 30, 1977
Prior to the PACT Act, Veterans with PD who served in one of the countries listed above were NOT previously eligible for PD service connection.
- Traumatic Brain Injury (TBI): Veterans with PD diagnosed with TBI may be eligible for additional disability benefits. In December 2013, VA released a final regulation recognizing PD and Parkinsonism as a secondary condition to service-connected moderate or severe TBI.
If I was exposed to Agent Orange and have PD or Parkinsonism, what benefits can I receive?
Veterans exposed to Agent Orange during military service may be eligible for:
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Agent Orange Registry health exam
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Health care benefits
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Disability compensation
What if I believe my PD is related to my military service, but I am not included in any of the service presumption categories?
Veterans who do not qualify for presumed service connection may still submit a claim if they have PD or Parkinsonism and a potential exposure during military service. Service connection can be granted if the Veteran is able to show a medical connection between the health condition and military service. Claims are reviewed on a case-by-case basis.
Where can I find more information/apply?
Agent Orange Helpline: 1-800-749-8387
Publications & Reports on Agent Orange
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VA’s Headache Centers of Excellence (HCoE) strive to help Veterans who experience chronic headaches such as migraine and cluster headaches. Since its start, the HCoE has been using data to understand care quality, care delivery and potential inequities in headache care delivery, locating at-risk groups to ensure they are getting the best possible care. Since 2008, almost 600,000 Veterans have gotten treatment for migraines within the VA.
“We really have a large toolbox. A lot more tools than what we used to have to be able to care for a Veteran with different types of headaches,” said Dr. Jason Sico, National Director of the Headache Centers of Excellence.
Although headaches are not limited to people who have had traumatic brain injury (TBI), reports that over 350,000 Veterans sustained a TBI during the Global War on Terror led Congress to establish the VA Headache Centers of Excellence in 2018 to care for Veterans experiencing chronic migraines and other types of headache diseases.
Getting Help From Your Phone
Helping Veterans self-manage their headache symptoms is a crucial part of a successful treatment plan, and VA’s HCoE has developed the free Annie Headache Health Protocol for the Annie mobile app. Annie is widely available for most mobile devices and automates reminders for Veterans to take medication, sends tips for reducing stress, provides instructions to prepare for health care appointments and more.
“We really want to make sure that we are empowering Veterans so that they know exactly what they have, have ways that they can treat it, as well as different treatment options coming from a physician or their type of healthcare provider,” said Dr. Sico.
The Annie app was developed in partnership with the National Tele-Neurology Program (NTNP) and can be used independently or with assistance from a VA provider. The VA Annie app website goes into further detail about how to sign up on the app and answers any FAQs.
Expanding Accessibility and Education
The HCoE has also been working with NTNP to pilot a virtual Headache Nurse Education Clinic. In this telehealth clinic, Veterans meet individually with NTNP nurses to discuss the Veteran’s goals of headache treatment from a whole health perspective and possibly provide non-pharmacological recommendations. These virtual visits include review of headache symptoms and contributing factors followed by patient-tailored non-pharmacological recommendations, such as behavior and/or environment modifications, device use and mindfulness/stress reduction techniques.
Veterans are given additional VA Whole Health resources and other educational information to access on their own time. The program allows Veterans in rural and underserved areas to receive specialized treatment via telehealth.
Currently, the Headache Nurse Education Clinic operates in five NTNP sites. Next year, they plan to expand to five more. By combining telehealth and a variety of patient-centered, non-pharmacological approaches, the Headache Nurse Education Clinic is bringing the latest in research and treatment to Veterans no matter where they live.
VA is also updating its VA-DoD Headache Clinical Practice Guideline, a comprehensive document that gives 27 evidence-based recommendations about pharmacologic and non-pharmacologic options for management of every type of headache, including guidance on headache prevention as well as treatment options in the moment when headaches occur.
“We are continuing to learn about headaches and applying these lessons to improve treatments for Veterans,” said Dr. Sico. “We are working tirelessly to improve the care for our Veterans, and all those impacted by headaches and migraines.”
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