The 1960s

The Yale Epilepsy Center began about 40 years ago (1969) and was one of the very first such centers in the world. Dr. Gilbert Glaser, Chairman at Yale, recruited Dr. Richard Mattson in 1967 to join the faculty and develop a clinical epilepsy program to complement an ongoing basic science research activity. Dr. Mattson had fellowship training in epilepsy and clinical neurophysiology at the Mayo Clinic and while in the USAF had led a team in pioneering studies of the effect of sleep deprivation on the EEG and epilepsy.

Initial plans at Yale called for an inpatient diagnosis and treatment unit in the Connecticut Mental Health Center (CMHC), a newly constructed facility in the heart of the Yale Medical Center. A change in leadership in the psychiatry department led to shift in focus from medically oriented psychiatry to psychosocial and psychodynamic issues making development on their inpatient unit no longer an option. However, Drs. Richard Mattson and George Henninger (now Professor Emeritus of Psychiatry) collaborated in clinical neurophysiological studies of emotional stress on seizures. Stress interviews were conducted while polygraphic recording was conducted in another room. Newly developed videotape machines made it possible to record and easily play back the events simultaneously with the electrographic recordings.

The need to find a new site led Drs. Gilbert Glaser and Lewis Levy, Chief of Neurology at the VA in West Haven, to enlist the help of Dr. Warren Huber, National Chief of VA Neurology, to campaign for funds to establish such a unit. Meanwhile, Dr. Mattson set up a rudimentary unit at the VA using the principles of closed circuit monitoring begun in clinical studies at the CMHC. Although the simultaneous recording of seizures and electrographic changes had been done before by using movies, the simplicity of recording and replaying, erasing and editing the video tape represented a major breakthrough of feasibility for everyday diagnostic study. Patients were studied using a polygraph and an in-room video camera video monitoring the patient. The EEG was recorded in a separate room and the paper write-out was recorded by a camera mounted on the polygraph. The clinical and EEG were then combined and recorded on the videotape. The video camera equipment had to be purchased from the Burns Detective Agency, there being no vendors in the medical field for such equipment. In the late 1960's and early 1970's CCTV/EEG monitoring at the Yale/VA Unit was primarily conducted during the daytime hours when the EEG technician was available. This was a limitation because many relevant episodes occurred at night. When the technician in the epilepsy unit became pregnant and needed maternity leave, Dr. Mattson decided to train the nurses serving the unit to be EEG technicians. This made a dramatic change in function because expert medical staff nurses were available 24-hours a day, 7 days a week.