NewYork-Presbyterian Hospital Experts Offer the Latest Information and Treatments for Epilepsy Awareness Month

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Millions of Americans of all ages, races and ethnic backgrounds are living with epilepsy, making it the fourth most common neurological disorder in the country. Experts at New York-Presbyterian Hospital's two Comprehensive Epilepsy Centers are dedicated to providing the latest, most advanced treatments so that patients can maintain a high quality of life.

Millions of Americans of all ages, races and ethnic backgrounds are living with epilepsy, making it the fourth most common neurological disorder in the country. Experts at NewYork-Presbyterian Hospital's two Comprehensive Epilepsy Centers are dedicated to providing the latest, most advanced treatments so that patients can maintain a high quality of life.

Identifying Epilepsy

"Epilepsy should not be classified as a seizure disorder, but rather a neurological disorder with a potential impact on learning and memory functions, mood and behavior in the individuals with spontaneous seizures," says Dr. Cigdem Akman, director of pediatric epilepsy at NewYork-Presbyterian/Columbia University Medical Center. "Fortunately, recent advances in diagnostic testing including various brain imaging methods and genetic testing have allowed doctors to identify the underlying cause of epilepsy, which brings hope for novel treatment options."

Because of advances in brain imaging, doctors can recognize subtle structural brain abnormalities that cause epilepsy. As a result, certain patients are now candidates for the surgical treatment of epilepsy that may not have been considered in the past.

Minimally Invasive Treatments Bring Hope

Dr. Jeffrey Greenfield, pediatric neurosurgeon at NewYork-Presbyterian/Weill Cornell Medical Center, says, "Brain surgery remains the only true cure for epilepsy, and we try very hard to offer every possible option. With today's technology, we can better localize seizure onsets and use a very precise, minimally invasive technique to remove epilepsy-causing brain tissue while not damaging the surrounding areas."

Rather than performing large operations to implant electrodes on the surface of the brain to record seizures, Dr. Neil Feldstein, director of pediatric neurosurgery and Dr. Guy McKhann, director of epilepsy and movement disorder surgery at NewYork-Presbyterian/Columbia are focused on a safer and less invasive technique of Stereo-EEG. Through a 2 millimeter incision, several small electrodes are implanted in the skull to detect where the seizures arise in the brain. "The Stereo-EEG technique has completely changed how we approach many complex epilepsy patients, making their evaluation both safer and more accurate," says Dr. Feldstein.

Dr. McKhann and Dr. Theodore Schwartz, neurosurgeon at NewYork-Presbyterian/Weill Cornell, are treating epilepsy with MRI-guided laser thermal ablation. "Through just a 3 millimeter incision, a laser is placed into a seizure focus to destroy the tissue causing the seizures," says Dr. Schwartz. "The procedure takes just a few hours and most patients go home the next day." Dr. McKhann adds that "our extensive experience to date treating epilepsy with laser ablation has been extremely positive, with a high rate of success, minimal side effects and no major complications."

Brain Stimulation Gives Patients a New Option

The FDA's recent approval of the responsive neurostimulator (RNS) represents a major breakthrough for adults with partial onset seizures who have failed to respond to antiepileptic drugs. The device is surgically implanted into the skull with electrodes on or in the brain that detect abnormal electrical activity. The device then responds by delivering electrical stimulation to normalize brain activity before a seizure occurs. "This is the first new treatment since 1997, which is a big leap for treating epilepsy," says Dr. Douglas Labar, director of the division of clinical neurophysiology at NewYork-Presbyterian/Weill Cornell. He and Dr. Carl Bazil, director of the Comprehensive Epilepsy Center at NewYork-Presbyterian/Columbia, lead teams of physicians who can actually monitor a patient's brain activity remotely through the neurostimulator. "In refractory patients where the site of seizure onset can be found, but surgery is not an option, this device allows localized treatment without additional medication, and can significantly reduce seizures," says Dr. Bazil.

How to COPE

There are medical, behavioral and emotional concerns for patients living with epilepsy at any age. NewYork-Presbyterian's Care and Outreach for People living with Epilepsy program, or COPE, addresses these concerns through a combination of free seminars, workshops, and support groups. This is an opportunity for individuals to normalize, socialize, eradicate stigma, learn from one another and to form a network of support. For more information, call 212-746-2471.

NewYork-Presbyterian Hospital

NewYork-Presbyterian Hospital, based in New York City, is one of the nation's largest and most comprehensive hospitals and a leading provider of inpatient, ambulatory and preventive care in all areas of medicine. With some 2,600 beds and more that 6,500 affiliated physicians and 20,000 employees, NewYork-Presbyterian had more than 2 million visits in 2013, including close to 15,000 infant deliveries and more than 310,000 emergency department visits. NewYork-Presbyterian comprises six campuses: NewYork-Presbyterian/Weill Cornell Medical Center, NewYork-Presbyterian/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children's Hospital, NewYork-Presbyterian/The Allen Hospital, NewYork-Presbyterian/Westchester Division and NewYork-Presbyterian/Lower Manhattan Hospital. The hospital is also closely affiliated with NewYork-Presbyterian/Lawrence Hospital in Bronxville. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area, according to U.S. News & World Report, and consistently named to the magazine's Honor Roll of best hospitals in the nation. Affiliated with two world-renowned medical schools, Weill Cornell Medical College and Columbia University College of Physicians and Surgeons, NewYork-Presbyterian is committed to excellence in patient care, research, education and community service. For more information, visit http://www.nyp.org.

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Christina Stolfo
NewYork-Presbyterian Hospital
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