Level 3 and Level 4 Epilepsy Centers
How do I find the right Doctor to treat my seizures?
A Neurologist is like the Primary Care Physician of the brain. S/he treats a variety of diseases of the brain including Epilepsy, Multiple Sclerosis, Parkinson's Disease, Alzheimers Disease, ALS, Stoke, and Autism, just to name a few.
An Epileptologist specializes in treating people specifically with epilepsy and seizures. Epileptologists are neurologists who have completed 1 - 3 extra years of subspecialty training in epilepsy care and treatment. They have a more in-depth knowledge of epilepsy, and focus specifically on treating people living with seizures. They provide multidisciplinary support to help their patients manage all aspects of their seizures.
For people with epilepsy whose seizures are under control by medication, your neurologist can be the perfect choice.
For those people with epilepsy whose seizures are not successfully controlled by medication, it is a good idea to find a doctor who specializes in epilepsy and seizures – one who works at a Level 3 or Level 4 Epilepsy Center.
Epilepsy Centers are rated by the National Association of Epilepsy Centers based on the services they provide to their patients. In Northeast Ohio, we are so lucky to have the following Adult and Pediatric Level 4 Epilepsy Centers:
For those in Northeast Ohio, click the Hospital’s name above to learn more about their program and doctors/specialists. For those outside of Northeast Ohio, enter your state or zip code to find epilepsy centers in your area.
What is a Level 4 Epilepsy Center?
Epilepsy is a disease that is not easily understood. Many people know about Generalized Tonic Clonic Seizures – formerly known as Grand Mal Seizures, and have heard of Absence Seizures – formerly known as Petit Mal Seizures, but don't know much more about epilepsy and seizures.
When you go to an emergency room or a general doctor because you just had a seizure, often they are unaware that there is a spectrum of seizures – a variety of different types of seizures which have different symptoms. Once your seizure is over, often, there is not much to do to help you, so they immediately send you home.
Across the United States, hospitals can be rated for the epilepsy care they provide.
The emergency room story listed above summarizes the care you receive at a Level 1 Epilepsy Center.
A Level 2 Epilepsy Center provides a consultation with a neurologist on staff.
Level 3 and 4 Epilepsy Centers have neurologists who specifically focus on epilepsy – also known as epileptologists.
A Level 3 center provides the basic range of medical, neuropsychological, and psychosocial services needed to treat patients with refractory epilepsy. Level 3 epilepsy centers provide basic neurodiagnostic evaluations, as well as basic medical, neuropsychological, and psychosocial services. Some level 3 centers offer noninvasive evaluation for epilepsy surgery, straight-forward resective epilepsy surgery, and implantation of the vagus nerve stimulator. These centers do not perform intracranial evaluations or other more complex epilepsy surgery.
A Level 4 center provides the more complex forms of intensive neurodiagnostic monitoring, as well as more extensive medical, neuropsychological, and psychosocial treatment. Level 4 centers also offer a complete evaluation for epilepsy surgery, including intracranial electrodes and a broad range of surgical procedures for epilepsy.
In its published Guidelines, NAEC recommends when patients should be referred to a level 3 or 4 center. Delayed or denied referral may be detrimental to the patient’s health, safety and quality of life.
If your seizures have not been brought under control after three months of care by a primary care provider (family physician, pediatrician), further neurologic intervention by a neurologist, or an epilepsy center if locally available, is appropriate.
If you are seeing a general neurologist, and your seizures have not been brought under control after 12 months, you should request a referral to a specialized epilepsy center with an epileptologist.
Epileptologists are adult or pediatric neurologists who specialize in the treatment of epilepsy and seizures. Epileptoloigsts have completed an additional one to two years of sub specialty training in EEG and epilepsy.