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, 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.

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 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.

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.

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.

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.

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.

To honor the legacy of Edward B. Bromfield, MD, a superb clinical neurologist, mentor, gifted teacher and research collaborator, the Brigham and Women’s Division of Epilepsy has renamed their epilepsy program, which he created nearly two decades ago.

The newly named Edward B. Bromfield Epilepsy Program was founded by Dr. Bromfield in 1993 so that leading epilepsy specialists across disciplines could work together to offer the best possible care to patients in a comprehensive, coordinated fashion. A tribute to Dr. Bromfield was held at BWH December 7, 2009.

Dr. Bromfield was Chief of the Division of Epilepsy, EEG and Sleep Neurology until his death in 2009. His passion for improving the lives of people with epilepsy was an inspiration to his colleagues at BWH and medical professionals interested in epilepsy throughout New England and across the country. He is remembered for being a masterful clinician and teacher, a compassionate and energetic doctor and as someone with an enormous heart.

“He was a fierce advocate for patients and worked tirelessly here at the hospital and in the community, volunteering his time to help patients with epilepsy,” said Barbara Dworetzky, MD, who succeeds Dr. Bromfield as division chief. “But, most of all, he treated everyone with great kindness and respect and was loved for who he was as a person, as well as a physician.”

“We are naming our program after him to pay tribute to his legacy and honor the many patients we see who remind us of his great dedication and determination. We want to keep his spirit alive here forever,” she said.

The Patient Comes First

Patients were his top priority, and Dr. Bromfield was devoted to them. He earned the prestigious J. Kiffin Perry Award for Excellence in Epilepsy Care in 2007 from the American Epilepsy Society.

His large following of devoted patients at BWH attests to that. “Dr. Bromfield saved my life,” one of his patients wrote in a nomination for the award. “He did the basic tests, but then we developed this unspoken language…he didn’t just give me medications, he understood what it means to have epilepsy.”

Dr. Bromfield always expressed his genuine concern for each of his patients and served as an example to his colleagues. “His incredible memory for patients was legendary,” said Tracey Milligan, MD, director of the Brigham and Women's Faulkner Hospital Epilepsy/EEG Program. “He listened and remembered specific details about patients he hadn’t seen in years.”

A Special Place for Children

Even beyond hospital walls, Dr. Bromfield’s passion for serving those with epilepsy manifested itself in a way that touched the lives of hundreds of children. In 1999, he and his colleagues founded Camp Wee-Kan-Tu, the first overnight summer camp solely for children with epilepsy. This enormous effort was a collaboration between Dr. Bromfield, social workers from BWH and the staff and leadership of the Epilepsy Foundation of Massachusetts and Rhode Island, for which he served as president for several years. Dr. Bromfield, who served as the camp’s medical director for many years, took a personal interest in making the children’s experience unforgettable. He often joined the kids in shooting hoops, playing baseball or singing around the campfire.

Unparalleled Contribution to Scientific Understanding of Epilepsy

Dr. Bromfield authored and co-authored many thoughtful papers and chapters, advancing the understanding of epilepsy. His areas of interest included new drug development, neuroimaging, status epilepticus and epilepsy surgery. Among his other areas of expertise were the diagnosis and treatment of non-epileptic seizures; sleep and epilepsy; quality of life for people with epilepsy; and the effects of maternal drug treatment on pregnancy and fetal outcomes. He was frequently invited to speak around the United States and internationally.

A Passionate Teacher and Mentor

Dr. Bromfield was a role model for neurology fellows, residents and medical students, as he demonstrated the ideal life balance in his devotion to family and friends, jazz and sports. He was beloved by his fellows, many of whom stayed close to continue to work and be inspired by him. In 2005, he won Co-mentor of the Year from the Harvard Partners’ Neurology Residents for his open-door policy, which his residents loved to take advantage of. He was honored again by the Harvard Partners’ Neurology Residents, who chose him as Teacher of the Year in 2007.

His mentorship, sense of humor and contributions to epilepsy care and research have left an indelible mark on BWH and throughout the field of neurology. In a two-page memoriam that appeared in the journal Epilepsy & Behavior, Orrin Devinsky, MD, professor of Neurology Neurosurgery and Psychiatry at NYU School of Medicine wrote: “Ed Bromfield was a truly loved colleague, mentor, and friend to many in neurology, epilepsy and other communities. A gentle giant, he was equal parts compassion, passion, and intelligence. One could not find a better friend or a better doctor.”