Refractory Epilepsy Clinic

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When seizures don’t respond to initial treatments, it can feel overwhelming. The specialists with the Refractory Epilepsy Clinic are here to help. We work closely with you to understand the full picture of your child’s epilepsy and find the most effective path forward.

If your child has refractory seizures, also called drug-resistant epilepsy, uncontrolled seizures or intractable epilepsy, it means seizures continue even while taking prescribed antiseizure medications.

What to Expect at Your Child’s First Visit

Your child’s first visit to the Refractory Epilepsy Clinic is designed to give our team a complete picture of your child’s health and to provide your family with a clear care plan.

To make the most of your time together, come prepared with a list of your child’s current and past medications, including notes on whether they have been effective, as well as any videos of your child’s seizures.

Be sure to have previous test results, such as MRI scans and electroencephalogram (EEG) records, transferred to us before your appointment.

During your visit, your child’s epileptologist will thoroughly review your child’s condition, including how long they’ve been having seizures, what treatments have been tried, and how epilepsy and treatments impact your family’s lives. Depending on your child’s needs, you may meet a broader care team that includes a nurse navigator, neuropsychologist, dietitian, neurosurgeon, epilepsy surgery navigator and social worker all focused on coordinated care for your child.

Our team also may recommend additional testing, such as a repeat epilepsy focused MRI, advanced imaging or further EEG monitoring, to better understand what’s causing your child’s seizures. From there, we’ll explain all available options, which may include newer or more advanced medications or a conversation about surgical treatments.

Once testing is complete and recommendations are made, our team will outline a personalized plan and make sure your family has the resources you need. That may include:

  • A seizure action plan for school or daycare
  • Guidance on a 504 plan and accommodations
  • Rescue medication
  • Information about seizure monitoring devices
  • Changes in diet, such as the ketogenic diet

How We Approach Your Child’s Refractory Epilepsy

We know that every child’s experience with epilepsy is different. Our team works closely with your family to understand your child’s needs, answer your questions and guide you through each step of care.

A Thoughtful, Step-by-Step Approach

Our first priority is to better understand your child’s seizures. To do this, we may recommend specialized testing, such as:

  • Brain wave recordings (EEG)
  • Advanced imaging (MRI)
  • Other studies to safely map important brain functions

These tests help us answer key questions:

  • Where do the seizures start in the brain?
  • How might that area affect speech, movement, memory or learning?

Personalized Care for Your Child

With this detailed information, we create a treatment plan tailored specifically for your child. Our goal is always to find the safest and most effective way to reduce or stop seizures, while protecting your child’s development and enhancing quality of life.

Throughout this process, you are an essential part of the team. We take time to explain results clearly, discuss options and support you in making confident decisions for your child.

Modified Diet for Children With Refractory Epilepsy

Research shows that some children who follow a ketogenic diet, modified Atkins diet or low glycemic diet experience a reduction in seizure frequency. These diets limit carbohydrates and are high in fat and moderate in protein. This type of diet is thought to help by altering the brain’s excitability through fueling the body with fats and proteins rather than carbohydrates. Our team works with your family to decide whether one of these diets is right for your child and to support you in day-to-day management.

Our multidisciplinary care team includes a dietitian who can guide you and your child on meal plans that may help control epilepsy and reduce seizure activity. Children treated with epilepsy diets are monitored at the Norton Children’s Ketogenic Diet Clinic with regular checkups to track growth, bone health, electrolytes and other health metrics.

Surgical Interventions for Refractory Epilepsy

When medications and dietary approaches aren’t enough, epilepsy surgery may offer a path to seizure reduction or the possibility of eliminating seizures. Our team includes a pediatric neurosurgeon, neuropsychologist and epilepsy surgery navigator who work alongside your child’s epileptologist to evaluate whether brain surgery is the right option. Surgery usually is offered after discussing all options, risks and benefits with you in detail.

We use advanced imaging, such as Surgical Theater technology and testing to understand exactly where seizures originate and how surgery, including new and minimally invasive options, might affect critical brain functions before any decisions are made.

Why Choose Norton Children’s Neuroscience Institute for Your Child’s Epilepsy Care?

  • Highest level of care: Since 2013, we’re home to Kentucky’s only Level 4 Comprehensive Epilepsy Center specifically for children, the highest rating available from the National Association of Epilepsy Centers.
  • Advanced surgical options: Epilepsy surgery is one of the most underused treatments available for refractory epilepsy, yet it is now safer and more effective than ever thanks to technological breakthroughs and depth of experience. All techniques are available at Norton Children’s.
  • Advanced surgical technology: Visualase, a real-time thermal imaging and laser system, allows our neurosurgeons to perform MRI-guided laser ablation surgery, a minimally invasive procedure; fewer than two dozen pediatric hospitals in the U.S. offer this technology.
  • Virtual reality planning: Surgical Theater creates an immersive 3D view of the brain, helping neurosurgeons, patients and families visualize specific brain regions contributing to and impacted by epilepsy and potential treatment impact; Norton Children’s Hospital is the first hospital in the region to use it.
  • Specialized neuropsychology support: Comprehensive assessments reveal how epilepsy impacts cognitive, emotional and behavioral development, providing detailed insights that inform treatment decisions, maximize results while minimizing treatment impact and support long-term success.
  • Dedicated inpatient epilepsy monitoring unit: Eight-bed unit at Norton Children’s Hospital, with an additional two beds at Norton Women’s & Children’s Hospital, allow children with epilepsy, unexplained seizures or other neurological episodes to receive continuous electroencephalography (EEG) monitoring and specialized care.
  • Comprehensive care team: Our dedicated team includes pediatric specialists, including epileptologists, neurologists, neurosurgeons, neuropsychologists, neuroradiologists, neurophysiologists, trained nurses, dietitians and social workers.
  • Convenient access statewide: Pediatric neurology clinics in Bowling Green, Elizabethtown, Frankfort, Owensboro, Paducah and Shepherdsville, Kentucky, plus telemedicine options provide closer follow-up, so families can receive specialized care closer to home.
  • Streamlined, family-centered care: In-office EEG and laboratory services are available at our downtown Louisville location.
  • Pioneering treatments: First in Kentucky and among few centers in the nation to use neurostimulation devices when seizures remain difficult to control. These include deep brain stimulation (DBS), responsive neurostimulation (RNS) and vagal nerve stimulation (VNS).

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