Adithya Sivaraju, MD, MHA

Dr. Adithya Sivaraju is an epileptologist and clinical neurophysiologist whose research spans two complementary domains that define the continuum of epilepsy care: (1) surgical epilepsy with emphasis on cortical stimulation mapping and intracranial EEG analytics, and (2) acute symptomatic seizures and risk of epileptogenesis. Across both areas, his work combines rigorous clinical observation, quantitative EEG interpretation, and methodical protocol design to clarify mechanisms, standardize practice, and improve patient outcomes.

1. Surgical Epilepsy and Stimulation Mapping

In parallel, Dr. Sivaraju has been a leader in advancing functional mapping for drug-resistant focal epilepsy. His group developed a multitask extra-operative stimulation-mapping protocol that captures language and cognitive networks with greater reliability and reproducibility. By systematically combining multiple paradigms—naming, verb generation, reading, and auditory comprehension—his approach recognizes that eloquent cortex is polyfunctional and spatially distributed, challenging the traditional binary notion of “language area vs non-language area.”

These efforts culminated in a landmark Neurology publication, “Multitask Language Mapping to Visualize the Spatial Configuration of Polyfunctional Language Cortex,” accompanied by an editorial highlighting its contribution toward standardizing direct electrical stimulation (DES) methodology. The paper established practical guidelines for stimulation thresholds, task selection, and data interpretation.

Beyond mapping itself, Dr. Sivaraju’s research integrates intracranial EEG features—including cortico-cortical evoked potentials (CCEPs) and frequency-specific markers—to better delineate functional and epileptogenic networks. His studies on the N2 area-under-the-curve metric have demonstrated its potential as an objective correlate of effective connectivity and post-resection outcome.

Collectively, his surgical-epilepsy research seeks to transform stimulation mapping from a descriptive art into a quantitative and reproducible process that guides both resection and neuromodulation strategies. The work reflects a consistent philosophy: meticulous data collection, iterative protocol refinement, and translation of electrophysiologic insight into actionable surgical decisions.

2. Acute Symptomatic Seizures and Epileptogenesis

Dr. Sivaraju leads multicenter investigations into the natural history and management of acute symptomatic seizures (ASyS)—seizures occurring in the context of acute brain injury whose long-term significance has long been under-defined. As a founding investigator of the PASSION ( Post-Acute Symptomatic Seizure Investigation and Outcomes Network ) consortium, he has established one of the largest prospective ASyS cohorts to date, encompassing patients with stroke, intracerebral hemorrhage, traumatic brain injury, and hypoxic-ischemic encephalopathy.

His research has clarified the risk of subsequent unprovoked seizures and helped define when acute events transition to epilepsy. Through careful EEG phenotyping and longitudinal follow-up, his group demonstrated that persistent epileptiform discharges on outpatient EEG after hospital discharge are among the most robust predictors of future epilepsy—surpassing traditional clinical and radiographic variables. This work, published and presented in leading journals and national meetings (Neurology, Epilepsia, Annals of Neurology), has laid the groundwork for a tiered risk model that categorizes post-ASyS patients as low (<30%), intermediate (30–60%), or high (>60%) risk for epilepsy.

He is now leveraging this framework to guide antiseizure medication (ASM) discontinuation strategies and design pragmatic clinical trials that balance overtreatment against prevention of epileptogenesis. The overarching goal is to build an evidence-based pathway from the intensive-care unit to long-term outpatient follow-up, using EEG as a readily available biomarker to refine prognostic accuracy and personalize therapy.