Ethan Rhodes
If you or someone close to you is suffering from epilepsy, it is important to find a good epilepsy center that can provide specialized care. The National Association of Epilepsy Centers (NAEC) supports strong epilepsy centers and provides a search tool to find accredited centers in your area or state. The Comprehensive Epilepsy Center at Northwestern Memorial Hospital in Chicago, IL, for example, has the highest NAEC designation. UCSF Health in San Francisco is ranked among the top 10 hospitals in the nation and provides state-of-the-art diagnostic imaging and treatment for all forms of epilepsy. NYU Langone Health's Comprehensive Epilepsy Center in Manhattan is another great option, as it has Level 4 accreditation from the NAEC, recognizing its expertise and facilities for providing the highest-level medical and surgical care for complex epilepsy cases. The Johns Hopkins Epilepsy Center is also renowned for its unparalleled experience in treating both children and adults with complex seizure disorders. These centers offer a range of services, from diagnosis and imaging to personalized treatment plans and surgery, to help improve seizure control and maximize patients' quality of life.
| Characteristics | Values |
|---|---|
| Hospital with the most epilepsy and seizure visits | Cleveland Clinic Main Campus, Cleveland, Ohio |
| Second most epilepsy and seizure visits | University Hospital, Ann Arbor, Michigan |
| Third-highest epilepsy and seizure visits | Boston Children's Hospital, Boston, Massachusetts |
| Nationally ranked in 13 adult specialties and 4 pediatric specialties | NYU Langone Hospitals, New York, NY |
| Nationally ranked in 13 adult specialties and 11 pediatric specialties | UCSF Health-UCSF Medical Center, San Francisco, CA |
| Nationally ranked in 14 adult specialties and 11 pediatric specialties | New York-Presbyterian Hospital-Columbia and Cornell, New York, NY |
| Nationally ranked in 11 adult specialties | Rush University Medical Center, Chicago, IL |
| Nationally ranked in 11 adult specialties | Northwestern Medicine-Northwestern Memorial Hospital, Chicago, IL |
| Nationally ranked in 15 adult specialties and 11 pediatric specialties | Johns Hopkins Hospital, Baltimore, MD |
| Nationally ranked in 11 adult specialties | Hospitals of the University of Pennsylvania-Penn Presbyterian, Philadelphia, PA |
| Nationally ranked in 12 adult specialties | UT Southwestern Medical Center, Dallas, TX |
| Nationally ranked in 14 adult specialties and 1 pediatric specialty | Massachusetts General Hospital, Boston, MA |
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What You'll Learn
Top US hospitals for epilepsy treatment
Cleveland Clinic Main Campus, Ohio
The Cleveland Clinic in Cleveland, Ohio, is the hospital with the most epilepsy and seizure visits in the US. It is also one of the largest hospitals in the country, accounting for 2.21% of all epilepsy and seizure diagnoses. The hospital's Epilepsy Center is one of the largest facilities in the world that specializes in epilepsy.
University Hospital, Michigan
The University Hospital in Ann Arbor, Michigan, is part of the University of Michigan health system. It accounts for 1.33% of all epilepsy and seizure diagnoses in the US.
Boston Children's Hospital, Massachusetts
Boston Children's Hospital is one of the most respected hospitals in the country, ranking as the number one children's hospital for nine consecutive years. It accounts for 1.21% of all epilepsy and seizure diagnoses in the US. The hospital has a strong focus on pediatric neurology and various pediatric specialties.
NYU Langone Health, New York
NYU Langone Health in New York City provides personalized treatment to improve seizure control and quality of life for people with epilepsy. Their Comprehensive Epilepsy Center includes neurologists, neurosurgeons, and epileptologists who treat all kinds of epilepsy and seizure disorders. They also offer a Pediatric Epilepsy Program as part of their center, with pediatric neurologists and experts who care for infants and children.
Mount Sinai, New York
Mount Sinai's Level 4 Epilepsy Center in New York offers the highest level of expertise and advanced treatment for seizures due to epilepsy. Their epileptologists and neurosurgeons provide comprehensive diagnosis and a full range of medication-based and surgical treatment options.
Johns Hopkins Hospital, Maryland
Johns Hopkins Hospital in Baltimore, Maryland, is nationally ranked in 15 adult specialties and 11 pediatric specialties. The Johns Hopkins Epilepsy Center has extensive experience treating both children and adults with complex seizure disorders. The center has earned a Level 4 accreditation from the National Association of Epilepsy Centers (NAEC), the highest ranking provided by the NAEC.
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Surgical options for epilepsy
One type of surgery is a lesionectomy, which involves removing a lesion that causes focal seizures. This procedure is considered for patients with a focal structural abnormality in the brain, such as a tumor or vascular malformation. Multiple subpial transections are another type of surgery used when seizures originate in a region of the brain that cannot be removed safely, such as areas controlling speech or movement. This involves making a series of fine, shallow cuts into the brain's gray matter.
Corpus callosotomy, or split-brain surgery, is an option for patients with severe generalized epilepsy and frequent seizures that lead to falls. This procedure involves cutting the corpus callosum, a band of nerve fibers connecting the two hemispheres of the brain, to prevent the spread of seizures from one side of the brain to the other. Functional hemispherectomy is a similar procedure where the surgeon disconnects one hemisphere of the brain that is not functioning properly without removing it entirely.
Deep brain stimulation involves inserting electrodes into a specific area of the brain to stimulate it and help stop the spread of seizures. This method is used for adults who have not responded to medication and are not candidates for other surgeries. Laser interstitial thermal therapy, or laser ablation surgery, is a minimally invasive procedure that uses MRI to map out the exact area of the brain to operate on and deliver laser treatment without opening the skull.
Other surgical options include temporal lobe resection, hemispherectomy, vagus nerve stimulation, responsive neurostimulation, and stereotactic radiosurgery, which uses focused radiation beams to treat the area of the brain where seizures begin. These procedures aim to remove the area of the brain causing seizures, disrupt nerve pathways, or implant a device to treat epilepsy.
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Epilepsy diagnosis and treatment for children
Epilepsy is one of the most common nervous system disorders, affecting children and adults of all races and ethnicities. It is characterized by recurring seizures, which occur when there is a burst of abnormal electrical signals in the brain, interrupting normal brain signals. The diagnosis and treatment of epilepsy are similar in children, teenagers, and adults, although the former group faces unique challenges.
The diagnosis of epilepsy has become a multilevel process, with three levels of classification: seizure types, epilepsy type, and epilepsy syndrome. Doctors will also seek to understand the etiology of the individual's epilepsy, or in other words, the cause of the seizures. In children, the most common causes of seizures are fever and infections of the CNS (central nervous system). Other causes include hyponatremia, accidental ingestion of toxic agents, abnormalities of the CNS, and genetic and metabolic disorders.
When it comes to treatment, some children may need to take medication for life to control their seizures. However, about 70% of children with epilepsy have normal mental development and are as intelligent as children without the condition. In some cases, children may be taken off medication if they have not had seizures for 1 to 2 years. If medication does not work well or causes side effects, other treatment options are available, such as surgery and dietary changes.
For example, a ketogenic diet, which is very high in fat and low in carbohydrates, has been shown to help control seizures. This special diet must be strictly followed, as too many carbohydrates can stop ketosis. Additionally, surgery for epilepsy can help, although it is associated with risks due to the removal of brain tissue. Vagus nerve stimulation is another procedure that has been used to treat epilepsy. It involves sending electrical signals to the vagus nerve, which then passes them on to the brain to prevent certain types of brain activity that can cause seizures.
Some of the top hospitals for epilepsy and seizure diagnoses in the United States include Cleveland Clinic Main Campus in Cleveland, Ohio; University Hospital in Ann Arbor, Michigan; and Boston Children's Hospital in Boston, Massachusetts. These hospitals are known for their expertise and comprehensive approaches to treating epilepsy and seizure disorders.
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Nutrition and epilepsy
While searching for the best hospitals for epilepsy, I came across the Cleveland Clinic Main Campus in Cleveland, Ohio, which is one of the largest hospitals in the country and accounts for 2.21% of all epilepsy and seizure diagnoses in the US. The second most visited hospital for epilepsy and seizure treatment is the University Hospital in Ann Arbor, Michigan, which is part of the University of Michigan Health System and accounts for 1.33% of all epilepsy and seizure diagnoses in the US. The third-highest number of epilepsy and seizure diagnoses are made at Boston Children's Hospital in Boston, Massachusetts, which is ranked as the number one children's hospital in the country. NYU Langone Health, which has locations in New York City and Florida, is another healthcare provider with a Comprehensive Epilepsy Center that provides personalized treatment for epilepsy and seizure disorders. Mount Sinai's Level 4 Epilepsy Center in New York is another option that offers advanced treatment for seizures caused by epilepsy.
Now, let's discuss the role of nutrition in epilepsy:
Nutrition and diet can play a significant role in managing epilepsy and seizure disorders. Studies dating back to the 1920s have shown that certain diets can improve seizure control in people with epilepsy. The ketogenic diet, a strict high-fat, low-carbohydrate dietary regimen, has been the focus of much of this research. The ketogenic diet induces a metabolic state called ketosis, where the body's cells use ketones, derived from the breakdown of fats, for energy instead of glucose, which comes from carbohydrates. This state of ketosis mimics a fasting state, and it has been observed that seizures often decrease or disappear during fasting in some individuals with epilepsy. The modified Atkins diet is a less restrictive alternative to the ketogenic diet, allowing for a more generous intake of carbohydrates and some foods like breads and cakes, as long as daily carbohydrate intake remains within prescribed limits. The modified Atkins diet has been studied alongside other diets like the Low Glycemic Index treatment, and they share the feature of eliminating sugar and sweets. Even simple but consistent diet changes, such as adopting a natural, whole foods diet, can improve seizure control without requiring medical supervision.
The choice of dietary regimen for epilepsy should be made on an individual basis, considering factors such as the patient's age, family environment, epilepsy type, nutrition status, and responsiveness to other treatments. Dietary interventions like caloric restriction and gluten-free diets can also have beneficial effects on neuroprotection and refractory epilepsy. The ketogenic diet has been particularly effective in treating Doose syndrome, an epileptic encephalopathy, with retrospective studies showing a significant reduction in seizures. However, long-term follow-up is necessary to monitor the potential impact on growth and the risk of developing cardiovascular-related conditions later in life.
Nutritionists and dietitians play a crucial role in helping people with epilepsy implement these dietary changes and ensuring they receive adequate support to improve their dietary habits. It's important to note that even small amounts of sugar can reverse the effects of certain diets and trigger seizures, so vigilance is required to avoid sugar in medications, vitamins, toothpaste, and other products. NYU Langone Health, for example, offers ketogenic and modified Atkins dietary therapies as part of their epilepsy treatment program.
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Epilepsy treatment in New York
There are several hospitals in New York that offer epilepsy treatment, with some specialising in treating challenging forms of epilepsy.
NYU Langone Health
NYU Langone Health has a Comprehensive Epilepsy Center that treats adults and children with epilepsy. The center holds weekly conferences that bring more than 20 members of the team together to develop the best treatment strategy for patients. The center provides the latest responsive stimulation therapies that allow them to manage epilepsy without operating on the brain. If surgery is required, patients are cared for by neurosurgeons from the advanced surgical program at NYU Langone's Tisch Hospital. The Manhattan location is accredited as a Level 4 Epilepsy Center by the National Association of Epilepsy Centers. The center also has an International Epilepsy Program to help patients travelling from abroad to obtain treatment.
NewYork-Presbyterian
NewYork-Presbyterian has a world-class team of epilepsy experts and facilities, including state-of-the-art Epilepsy Monitoring Units, which has earned them accreditation as a Level 4 Epilepsy Center. The center offers inpatient monitoring and outpatient care in Brooklyn, Queens, and Westchester County, with a range of telehealth options also available. They use advanced electrodiagnostic testing to evaluate brain function and seizures, including Electroencephalography (EEG or "brain wave test"), video-EEG monitoring, and intracranial monitoring.
Northwell Health
Northwell Health has four hospitals that are accredited by the National Association of Epilepsy Centers (NAEC), recognised for specialised expertise and exceptional services. These include Lenox Hill Hospital, a Level 4 Epilepsy Center, which provides complex and intensive neurodiagnostic monitoring, extensive medical treatment, and a range of surgical procedures. The center offers the latest diagnostic and therapeutic options for patients suffering from seizure disorders in new and comfortable surroundings. It includes a four-bed epilepsy monitoring unit (EMU) staffed 24/7 by dedicated observation personnel.
Columbia Comprehensive Epilepsy Center
The Columbia Comprehensive Epilepsy Center is dedicated to the evaluation and care of adults, adolescents, and children with epilepsy, with the goal of helping patients gain control of seizures and optimise their quality of life. The center offers advanced diagnostic testing, including inpatient adult and pediatric Epilepsy Monitoring Units (EMUs) that combine video and electroencephalography (EEG) monitoring to determine epilepsy type, frequency, and location of seizure onset in the brain. They also provide in-depth evaluations for the surgical treatment of epilepsy, as approximately half of patients whose epilepsy is not controlled by medication are candidates for epilepsy surgery.
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Frequently asked questions
The best hospital for epilepsy depends on your location, the type of seizures you are experiencing, and the kind of treatment you require. Here are some highly-ranked hospitals for epilepsy:
- The Comprehensive Epilepsy Center at Northwestern Memorial Hospital in Chicago, IL, has the highest designation by the National Association of Epilepsy Centers (NAEC).
- NYU Langone's Comprehensive Epilepsy Center in Manhattan provides the latest responsive stimulation therapies and is accredited as a Level 4 Epilepsy Center by the NAEC.
- UCSF Health's Epilepsy Center is ranked among the top 10 hospitals in the US and provides state-of-the-art diagnostic imaging and treatment for all forms of epilepsy.
- The Johns Hopkins Epilepsy Center has unparalleled experience treating both children and adults with complex seizure disorders and has earned a Level 4 Center accreditation by the NAEC.
A Level 4 Center accreditation by the National Association of Epilepsy Centers (NAEC) is the highest ranking provided by the NAEC. It recognizes epilepsy centers based on their expertise and capacity to provide a range of services to their patients.
An epilepsy center is a specialized facility that provides a team of specialists to help diagnose epilepsy and explore treatment options. Their goal is to provide the best seizure control and improve your quality of life. If you are unsure what type of seizures you are having or are having trouble controlling your seizures, it is recommended to find an epilepsy center to get the specialized care you need.
You can use the NAEC's search tool to find an epilepsy center in your area or state.
