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Local Epilepsy Care connects highest-need patients to UR Medicine

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The new epilepsy program at Cayuga Medical Center has established an important link with UR Medicine to care for patients needing the most complex epilepsy treatments. The Strong Epilepsy Center at the Rochester medical center is a Level 4 program, the highest level of care recognized by the National Association of Epilepsy Centers. The Rochester center opened in 1989 and is one of four Level 4 programs in upstate, and its 47 physicians, neuroscientists, technicians, nurses, and support staff provide care for about 600 patients annually.

The connections from Cayuga Medical Center’s epilepsy program to UR Medicine grew from the ground up. Neurologist Deana Bonno, MD, who directs Cayuga Medical Center’s Epilepsy Monitoring Unit, completed her residency in neurology and a fellowship in epilepsy/clinical neurophysiology at the University of Rochester before coming to Ithaca. She is also an assistant professor of clinical neurology at the University of Rochester. The Ithaca EMU uses the same monitoring equipment and software used at UR Medicine, which allows Dr. Bonno to rapidly exchange patient monitoring data for consultations with specialists at the Strong Epilepsy Center. A video link connects her and other neurologists to a conference room for semimonthly meetings with a dozen UR Medicine neuroscience specialists. During a conference, a digital projector displays brain wave studies and medical records on a wall-size screen, while a physician presents a case, proposes a treatment and defends the plan as other neuroscientists raise questions.

“It’s all very collegial, and we review every major case. We closely examine cases where brain surgery is being considered. A patient gets only one chance with brain surgery, so our entire team must agree that surgery will provide the most benefit for the patient with the least risk,” says Dr. Michel Berg, the chief of UR Medicine’s epilepsy program, where he began seeing patients in 1993.

Medications control seizures in about 70 percent of people with epilepsy, and surgery is used in about 10 percent of the cases. Low-carbohydrate diets and implantable pacemaker-like devices that use an electrical pulse to halt a seizure are also used to treat the disease. Some children with epilepsy may outgrow their condition with age. About 2 million Americans have epilepsy and about 4 percent of the U.S. population will develop a seizure disorder during their lives, with most cases occurring in young children and adults 65 and older.

The collaboration between the epilepsy programs at Cayuga Medical Center and UR Medicine is part of a growing partnership for the neurology programs at both hospitals. As the Cayuga Medical Center’s epilepsy program grows, it is expected to become a Level 3 Center and provide a range of specialized neuro-diagnostic monitoring, neuropsychological, psychosocial and medical services. Level 3 Centers are required to affiliate with a Level 4 Center such as at UR Medicine, where complex brain surgeries and extensive medical and psychological care are provided. Patients at the Cayuga Medical Center epilepsy unit who need surgery would have their operations in Rochester and follow-up care in Ithaca.

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