A level 4 epilepsy center provides the more complex forms of intensive neurodiagnostic monitoring, as well as more extensive medical, neuropsychological and psychosocial treatment. Level 4 epilepsy centers also offer a complete evaluation for epilepsy surgery, including intracranial electrodes and a broad range of surgical procedures for epilepsy.
In its published Guidelines, the National Association of Epilepsy Centers (NAEC), recommends when a person should be referred to a level 3 or level 4 center. Delayed or denied referral may be detrimental to the individual's health, safety and quality of life.
If your seizures have not been brought under control after three months of care by a primary care provider (family physician, pediatrician), further neurologic intervention by a neurologist or an epilepsy center — if locally available — is appropriate.
If you're seeing a general neurologist, and your seizures have not been brought under control after 12 months, you should request a referral to a specialized epilepsy center with an epileptologist. (source: National Association of Epilepsy Centers)