Yale Comprehensive Epilepsy Center

Yale New Haven Hospital is internationally recognized as a leader in innovative treatment for all types of epilepsy. In addition to clinical excellence and innovative research, the Yale Comprehensive Epilepsy Center at Yale New Haven was one of the nation's first and has evolved into one of the most active and advanced programs in the world.

Our Treatment Team and Services

With a Level 4 rating – the highest rating by the National Association of Epilepsy Centers – patients and families benefit from a model of care that integrates the expertise of the program’s clinical staff and advanced technology for diagnosis, seizure classification and treatment. Our epilepsy care team is composed of neurosurgeons, epileptologists, neuropsychologists, neuroradiologists, psychiatrists, social workers, dietitians, nurses, technologists, bioengineers and neuropathologists, with subspecialized pediatric and adult expertise.

At Yale New Haven Hospital, our team of dedicated experts offers a multidisciplinary approach to care that integrates the expertise of colleagues in neurosurgery and diagnostic imaging to deliver leading-edge evaluation, diagnosis, and patient care to individuals with varying forms and degrees of seizure and epilepsy. Our program provides intensive audiovisual and electroencephalography (EEG) monitoring for diagnosis and localization of the affected area to tailor each patient’s care. Patients receive comprehensive inpatient and outpatient services, as well as a full range of medical, surgical, dietary and device treatment options, including investigative therapies and approaches not widely available.

Patients needing inpatient treatment receive care on a specialized eight-bed neurological unit with staff specifically trained in epilepsy monitoring.

We also have an extensive critical care EEG monitoring program to detect and treat non-convulsive seizures and prolonged seizures known as status epilepticus. We monitor the brain activity (via EEG and other measures) of patients with acute brain injury to detect impending stroke seizures, and other conditions that may impede brain recovery.

The EEG lab can be reached at 203-688-2495.

Our program is located in New Haven; some physicians may also see patients at Yale New Haven Health facilities in Stamford and Guilford.

Epilepsy Surgery

The Yale Comprehensive Epilepsy Center at Yale New Haven has been instrumental in developing many of what are now widely practiced surgical procedures for epilepsy including the medial temporal lobe resection, corpus callosotomy, and intraoperative or extraoperative mapping of the primary functions of the cortex. Collectively, our specialty team brings more experience than almost any other program in the world to the patients treated at Yale New Haven Hospital. We offer numerous devices for epilepsy, including vagus nerve stimulation; responsive neurostimulation, which is a permanently implanted device that continuously reads the brain waves and provides tiny stimulations when a seizure tries to start; and minimally invasive laser ablations as an alternative to invasive epilepsy surgery.

Patients are supported by caregivers during each step of the process, so that a potentially very stressful experience can have the very best outcome both medically and emotionally.

The outcomes of epilepsy surgery are very encouraging. Many patients are completely seizure-free after surgery, with most others experiencing fewer or less severe seizures.

Our operating room suite has advanced digitized imaging, computerized 3-D placement of electrodes, sophisticated monitoring of brain activity during surgery, and advanced robotics to perform safe and optimal epilepsy surgical procedures.

The epilepsy surgery staff works closely with referring physicians throughout a patient's evaluation and treatment to maximize care continuity.

Deep Brain Stimulation for Epilepsy

Deep brain stimulation (DBS) is a newly approved treatment option for epileptic patients who do not have successful outcomes from prescribed medication. Up to 30 percent of patients with epilepsy have continued seizures despite correct dosage of anti-seizure medications. This is known as medication refractory epilepsy.

DBS is a less invasive surgical option for patients with medication refractory epilepsy and can be effective for a variety of patients with partial-onset epilepsy with or without spread of seizure activity from a part of the brain to all of the brain (known as generalization of seizures).

During deep brain stimulation surgery, electrodes are implanted into select areas of the brain via small holes made in the skull. In addition, a small, battery-operated stimulator device is placed within the chest and connected to the electrodes When stimulated by the small device, the electrodes adjust brain activity, reducing the number and severity of seizures.

The Yale Comprehensive Epilepsy Center and its Epilepsy Surgery Council evaluate potential DBS patients. The Yale Comprehensive Epilepsy Center also offers a Deep Brain Stimulation Support Group for patients and their loved ones who have undergone or are considering DBS to treat epilepsy.

Frequently Asked Questions about Deep Brain Stimulation

Based on the DBS clinical trial SANTE (Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy), patients showed a difference in seizure frequency a few months after surgery. The long-term outcome follow-up from this study shows that the results appear to improve over time.
After surgery, a patient will need to have the DBS device programmed by an epileptologist who is trained in DBS programming. Initially, programming sessions may occur every few weeks and then less frequently. Eventually, physician appointments would typically be every few months as is typical for patients with epilepsy.

The DBS system is presently FDA-approved for patients 18 years of age and older. Experience from DBS for movement disorders such as Parkinson’s disease has shown that this surgery is safe for most ages. DBS surgery may be performed on healthy persons in their 80s.  

The success rate of DBS for epilepsy is measured by changes in the seizure frequency and severity. These outcomes have been reported in two main ways. The primary measurement is the overall average decrease in seizure frequency. A patient with at least a 50 percent reduction in seizure frequency is considered a ‘responder’ to the therapy. Success is also measured by the percentage of patients who are responders to treatment (“responder rate”). Long-term follow-up suggests that after six years of therapy over 70 percent of patients are responders. 

Following FDA approval of DBS for treatment of medication refractory epilepsy in December 2018, the DBS system and treatment option was released to a select number of Epilepsy Centers across the United States. Yale New Haven Hospital was selected within the first group of hospitals to provide DBS surgery and therapy. Yale Comprehensive Epilepsy Center maintains a Level 4 rating – the highest rating by the National Association of Epilepsy Centers, and is one of the busiest DBS programs in the Northeast.
Yes, Medicare, Medicaid and an increasing number of private insurance programs have covered the treatment. Because DBS for epilepsy is a recently approved treatment option, there may be delays in getting insurance coverage from some providers.