The History of Epilepsy and Electroencephalography

Brigham and Women's Hospital's role on the forefront of epilepsy care is deeply rooted in the history of the field of epilepsy and electroencephalography (EEG), dating back to the early 1930s.

The "Father of Modern Neurosurgery"

Brigham and Women's Hospital's role on the forefront of epilepsy care is deeply rooted in the history of the field of epilepsy and electroencephalography (EEG), dating back to the early 1930s, when EEG first became available to hospitals. After World War I, Dr. Alexander Forbes and Dr. Donald J. MacPherson, both on staff at BWH, began animal research on EEG. Often called the “father of modern neurosurgery,” the famous American neurosurgeon and pioneer of brain surgery, Harvey Williams Cushing, MD, was one of the first surgeons to operate on patients with epilepsy at BWH - then called the Peter Bent Brigham Hospital - and at the adjacent Children’s Hospital Boston, which continues to have a collaborative relationship with BWH. Cushing graduated from Harvard Medical School, trained at Johns Hopkins University and was brought back to Boston to BWH from Johns Hopkins University. The famous neurologist William G. Lennox, MD, an associate in Neurology at BWH, who started the first epilepsy unit at Children’s Hospital, led the illustrious group of Harvard Medical School researchers who made numerous strides in the field of neurophysiology.

The first EEG that could be used on patients

Among this group was the great physiologist Hallowell Davis, MD, who was the first U.S. scientist to begin recording electrical activity of the human brain. Dr. Davis started what is now referred to as the Harvard School of EEG, along with Dr. Lennox and prominent research scientists Drs. Frederic and Erna Gibbs. By 1935, Albert Grass, a graduate of the Massachusetts Institute of Technology, joined this group, and a collaboration between Dr. Gibbs and Albert Grass, resulted in the first commercially successful EEG instrument that could be used on patients in a clinical setting. This first machine was sturdy and practical enough to survive a trip in the trunk of a Model-T Ford, where it was unveiled at a meeting of the American Medical Association in Kansas City. Here, EEG was demonstrated and the field of practical clinical EEG was born.

EEG becomes an invaluable tool during WWII

EEG drew considerable attention during World War II, when a school was started in Massachusetts to train EEG technicians who were sent overseas along with EEG machines that were built so well, they were put in crates and withstood being dumped into the ocean.  From this time until the first CAT scan was developed in the mid-1970s, EEG was the main test available to study the brain.

Epilepsy and EEG grow at BWH

Dr. H. Richard Tyler, the first neurologist at BWH and chairman for many years, opened the hospital’s first EEG laboratory in the 1950s. The BWH EEG laboratory was a forerunner and model for labs across the country. Dr. Tyler ran the BWH EEG laboratory and also saw patients at Children’s Hospital. His EEG technologist, Nanon E. Winslow, has been a leading technologist at BWH for more than 40 years and, in 2009, became the first recipient of the newly created Edward B. Bromfield Award for Excellence and Exceptional Commitment to Patient Care, Teaching and Clinical Collaboration, for her unparalleled commitment to EEG teaching and collaborative patient care. In the years following Dr. Tyler’s leadership, epilepsy patients were seen in the Division of Neurophysiology, which included EEG and the study of neuromuscular disease.

This division was under the leadership of Mark Hallett, MD, now head of the National Institute of Neurological Disorders and Stroke (NINDS). Dr. Shahram Khoshbin, MD, Dr. Hallett’s first BWH neurophysiology fellow, took over the leadership of the neurophysiology division from 1984 - 1993. He is currently an associate professor of neurology at Harvard Medical School and the department’s historian.

He has won numerous teaching awards at the medical school.  The neurophysiology division grew enough that EEG became a separate field from EMG/neuromuscular diseases before Dr. Bromfield was recruited to start the hospital’s first dedicated epilepsy program and lead the EEG program. Now, under the direction of Dr. Dworetzky, MD, the center has been renamed the Edward B. Bromfield Epilepsy Program. It continues to make strides in the understanding and advancement of care for people with epilepsy.

History of the Multidisciplinary Epilepsy Program at BWH

The Brigham and Women’s Comprehensive Epilepsy Program was founded in 1993, when the late Edward B. Bromfield, MD, a passionate, dedicated neurologist, was recruited from New England Medical Center to start the first comprehensive epilepsy program at Brigham and Women’s Hospital. Dr. Bromfield worked for eight years as the only epileptologist providing full services both in and out of the hospital. He handpicked first rate clinical staff, including Eileen Salmanson, LICSW, to begin to fulfill his vision of creating an outstanding multidisciplinary program where patients can expect top notch care and the full range of all needed specialized epilepsy services in one place. He brought in state-of-the-art video EEG monitoring equipment, and together with neurosurgeon Peter Black, MD, began offering surgical therapy to patients with epilepsy.  At the time, he recruited Dr. Barbara Dworetzky as the first epilepsy fellow in the multidisciplinary program at BWH. Dr. Dworetzky succeeds him as the new chief of the epilepsy division. There are currently eight physicians in the epilepsy practice, and the division has grown and flourished under their direction. Beginning December 7, 2009, at the BWH tribute for Dr. Bromfield, the BWH epilepsy program will change its name to the Edward B. Bromfield Comprehensive Epilepsy Program to honor and continue the work of the founder, who modeled outstanding care and advocacy for people with epilepsy.  Click here to learn more about our clinical staff.

Epilepsy staff opens Camp Wee-Kan-Tu: the first overnight camp for children with epilepsy in New England.

Camp Wee-Kan-Tu, the first local overnight camp for children with epilepsy, opened in 1998 through generous support by the Friends of Brigham and Women’s Hospital. The pioneering camp was founded by BWH social workers Eileen Salmanson and Jeffrey Robbins so that children and teens with epilepsy could have a safe environment where they can be themselves. Dr. Bromfield served as the camp’s medical director until 2006. He was joined by Dr. Suki Koh, and BWH neurosurgery nurse Sarajune Dagen. The program continues to offer novel social, recreational and educational programs. One innovative feature of the camp is that many of the counselors have firsthand experience with epilepsy and carry a greater understanding and empathy for the children who attend. Their presence provides the children with important role models, helping them to normalize the experience of having epilepsy. A scholarship for a camper to attend this camp has been named for Dr. Bromfield.

Dr. Bromfield’s impact beyond Brigham and Women’s Hospital

Although Dr. Bromfield was content to work passionately yet quietly on improving the lives of his patients, his notoriety and impact went far beyond the walls of BWH. He was a member of the American Epilepsy Society, the American Academy of Neurology and the American Neurological Association. He also served on the Professional Advisory Board of the Epilepsy Foundation of America.  In 2007, he was presented with the prestigious J. Kiffin Penry Award for Excellence in Epilepsy Care as a tribute to work that “has had a major impact on patient care and improved the quality of life for persons with epilepsy.” He was also known as a great teacher and mentor, as evidenced by his being chosen as Teacher of the Year, also in 2007, by the residents in the Harvard-Partners Neurology program.

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