Winthrop Comprehensive Epilepsy Center
The Winthrop Comprehensive Epilepsy Center is one of the most advanced and comprehensive programs on Long Island. As a level-4 Epilepsy Center, we have met or exceeded the most demanding patient care guidelines set forth by the National Association of Epilepsy Centers – there is no higher certification offered by the NAEC.
An important goal of the Winthrop Comprehensive Epilepsy Center includes seizure reduction, and possible seizure elimination with medical and surgical therapies.
The Center employs the leading-edge diagnostic evaluation with imaging, neurophysiologic monitoring, and neuropsychological evaluation to provide safe and effective surgical options for individuals with medication-resistant epilepsy. If one is considered a candidate for surgery, decision making is made through an integrated alliance with the epilepsy treatment team, primary care physician, and patient.
Our epilepsy center is dedicated to patient care and the most advanced and effective treatment options available. Many patients come to our program because they have not had success with conventional treatments. Because of our leadership in the field of epilepsy research, having participated in or led many major research projects and clinical trials, we are continuously formulating new and novel approaches to treatment.
What Is Epilepsy?
Epilepsy in its most basic form revolves around abnormal function in the brain. Most people equate epileptic seizures with strobe lighting, however this is just one of many triggers, most of which are not known. We do know that epilepsy can be caused by genetic factors, brain tumors or strokes, trauma affecting the brain and diseases including meningitis and AIDS.
Epileptic seizures come in two forms – focal and generalized. Focal, or partial, seizures occur in just one area of the brain and are categorized by the loss (focal dyscognitive or complex partial) or maintenance (simple partial) of consciousness. Generalized seizures affect the entire brain.
Since most epileptic seizures have a sudden onset, serious injury can occur if a sufferer is in the middle of an activity and dangerous falls are not uncommon.
Symptoms & Diagnosis of Epilepsy
The only outward symptoms of epilepsy are associated seizures and no two patients are the same. The duration and severity of a seizure can vary between patients and episodes. Some patients retain consciousness during their seizures, while others do not. With that said, individual patients will usually have similar seizures at each episode, since epilepsy is most often triggered by the same part or parts of the brain. Typical symptoms include:
- Disorientation or confusion
- Loss of consciousness
- A tick or abnormal movement of the head
- Staring blankly
- Uncontrollable movement of extremities
Our facility boasts exceptionally experienced clinicians and the latest technology in diagnostic imaging including neurophysiologic monitoring and neuropsychological evaluation. As a result, we are able to diagnose and treat epilepsy with unprecedented accuracy. Our multidisciplinary program combines our expertise with that of associated specialties to create a comprehensive plan for patient improvement.
All treatments here at our center are individualized – tailored to the specific needs of our patients. In fact, we hold a weekly multi-disciplinary meeting discussing each patient and the options available for their continued care. Treatment options may include:
- Medications to reduce the occurrence and severity of seizures can be an effective first step, avoiding more invasive treatment options. Some patients will respond well with few side effects, while others will not derive any benefit from medication.
- Vagus Nerve Stimulation involves the implantation of a pacemaker device under the skin. The electrical impulses generated by the pacemaker stimulate the vagus nerve, which, in turn, can assist with the frequency and severity of epileptic seizures. The procedure is performed on an outpatient basis and the pacemaker is programmed and adjusted based on the patient’s circumstance.
- Epilepsy Surgery may be the only option for some patients who do not respond to less invasive procedures and medications. By removing the portion of the brain causing the seizures themselves, we can improve quality of life, often dramatically. Suitability for surgery and prognosis depends largely on the affected part of the brain. Our team works closely with primary care physicians and patients themselves to create a treatment plan.
Epilepsy Support and Aftercare
Epilepsy is a chronic condition – one that will affect a patent and their family for the rest of their lives. As such, diagnosis and treatment alone does not fully address long-term quality of life. Here at our epilepsy center, we are dedicated to educating and supporting sufferers and their families – assisting them in coping with and compensating for this debilitating condition, often leading to safer, more normal day-to-day life.
We strive to provide comprehensive services to support and educate those with epilepsy, their families, and the community. Epilepsy, like other chronic conditions, impacts quality of life and everyday living. We fully understand the significant challenges people with epilepsy face every day and consider addressing these issues is tantamount in providing optimal care. The Center offers access to community resources, health information provided by epilepsy health professionals, and psycho-social support.
Epilepsy Monitoring Unit
An Epilepsy Monitoring Unit providing continuous video-EEG monitoring featuring a fully computerized digital recording system and 24-hour monitoring by highly experienced nurses and staff, where we offer both phase 1 and phase 2 monitoring:
Phase 1 Monitoring: Phase 1 monitoring involves inpatient monitoring with video-EEG. A standard EEG is applied and patients may be monitored for several days. Patients are continuously monitored and weaned off their medications is a safe setting. We record brain activity during seizures and between seizures. This information is often highly valuable for diagnosis of seizures, classification of seizures leading to optimal care, and localization for potential epilepsy surgery.
Phase 2 Monitoring: Some patients undergoing evaluation for epilepsy surgery require more invasive monitoring to determine the region of the brain where the seizures are originating from. The Winthrop Comprehensive Epilepsy Center team discusses every patient considered for phase 2 monitoring, and careful planning is made by the Epilepsy Center team. Electrodes are placed on the surface of the brain in the operating room, allowing for more detailed analysis of brain activity. The data obtained from phase 2 monitoring often provides valuable information for surgical planning. In addition, functional cortical mapping may be performed by stimulating the electrodes at the bedside.
Referrals: For referral information, please call the Neurology Practice at 516-663-4525. For direct referral for video- EEG monitoring, contact Terry Rodgers at 516-663-9097.
The Comprehensive Epilepsy Center Team
Neurologists with specialty training in epilepsy, electroencephalography (EEG), and clinical neurophysiology
Neurosurgeons with expertise in epilepsy surgery
Nurses and staff dedicated to the evaluation and management of epilepsy
- Manuel Gonzalez-Bermudez, G.MD, B.Sc, B.Lit, R.EEG.T, R.NCS.T, R.ULT.T, EP.T. – Director of Neurodiagnostic Services
- Kathy Krieger, RN
- Ellen McCarthy, Neurodiagnostic Lab Medical Secretary
- Terry Rodgers, RN, LCSW-R, ACSW, C-ASWCM
- Elizabet Portieles Sanchez, F.G.MD, B.Sc, B.Litt,, EEG/EMG/NCV Technician
- Golareh Sina, PA
EEG Technicians are highly trained in administering tests to detect epilepsy
- Monica Amorin, EEG Technician
- Doris Bermudez, Supervisor/ EEG Technician
- Michael Giacoia, Neuro Vascular Technician
- Karen Greco, EEG Technician
- Florence Ingrassia, EEG Technician
- Janet Mojica, EEG Technician
- Christopher Moses, EEG Technician
- Demetrius Simmons, EEG Technician