Providing the most effective epilepsy treatment for your child largely depends on making sure we have a complete and accurate diagnosis. We understand that this process can be overwhelming, and our team at Norton Children’s Neuroscience Institute will guide your family every step of the way.
As an accredited Level 4 epilepsy center by the National Association of Epilepsy Centers, we offer advanced diagnostics and treatments, and provide the highest level of specialized, multidisciplinary care for difficult-to-treat epilepsy.
About 70% of patients with epilepsy and seizures are treated successfully with antiseizure medications, giving these children long-term freedom from seizures. Our team of epilepsy specialists has vast experience with all medical options available, including cutting-edge medications.
After reviewing the child’s past and current list medications, as well as dosages, side effects and interactions with any other medications, we will make recommendations based on the type of seizure, the child’s age, side effects and cost. We will work with the family to choose the most appropriate medicine.
Our team will follow up frequently and monitor the treatment’s effectiveness. We will make adjustments as needed and review the medications on a regular basis.
For the 30% of patients who do not respond to medications, they are considered to have drug-resistant epilepsy, also called refractory epilepsy. Drug-resistant epilepsy is defined as failing to achieve seizure control after trying two medications.
Patients with drug-resistant epilepsy may benefit from other treatments, such as epilepsy surgery or the ketogenic diet. To determine which therapy is best for the patient, an in-depth evaluation, called a Phase 1 evaluation, is ordered.
Phase 1 evaluation consists of completing a set of tests to identify the type of seizures the patient has and determine which parts of the brain are causing the seizures. In addition to blood tests and taking a thorough medical history, Phase 1 will include a variety of diagnostic tests that includes some or all of the following:
After the testing is completed, the child’s test results are reviewed during a weekly epilepsy surgery team conference attended by neurologists, neurosurgeons, radiologists, neuropsychologists and nurses all caring for patients with epilepsy. Each case is discussed carefully, and a collective plan is crafted to choose the best treatment option for each child.
If the patient’s seizures are focal, arising from one part of the brain, but Phase 1 testing cannot precisely map this area, a Phase 2 evaluation involves additional, more advanced testing to further map the brain and evaluate the possibility of surgery.
Phase 2 involves a surgery to carefully place very small EEG electrodes in selected parts of the brain that are chosen based on Phase 1 results. This procedure is called stereo EEG, or SEEG. Advanced software is used to take images of the brain and plan the location of the electrodes. This allows the team to accurately map where the seizures are happening in the brain and ensure that a corrective surgery can be done effectively and safely.
From consultation through surgery and recovery, we guide families through each step of the surgery journey. Our multidisciplinary team includes pediatric neurosurgeons, epileptologists and neuropsychologists who will collaborate to create a personalized plan that is most suited for each child and family.
If the child meets the criteria for epilepsy surgery after the evaluation process, we will discuss the most appropriate treatment option, including minimally invasive procedures, to control or completely eliminate the child’s seizures.
As the region’s leader in pediatric epilepsy care, we offer sophisticated treatment options. Our dedicated surgical suite in Norton Children’s Hospital is specifically designed for complex pediatric procedures. The advanced tools allow our neurosurgeons to precisely map the child’s brain and plan the safest, most effective approach for their unique needs.
Any patient who has tried two or more medications and continues to have seizures can be considered for epilepsy surgery after completing Phase 1 testing.
The goal of surgery is to significantly reduce the severity and frequency of seizures, ideally eliminating them completely.
Your child’s provider will discuss the surgery type, if needed, and corresponding recovery therapy. The Norton Children’s Ketogenic Diet Clinic also may be recommended after treatment.
Your child’s epileptologist, a neurologist who is an epilepsy specialist, collaborates with a multidisciplinary team that includes a clinical pharmacist trained in caring for children with epilepsy.
Research shows that some children who follow a ketogenic diet, modified Atkins diet or low glycemic diet experience a reduction in their seizures. These diets, which limit carbohydrate intake, are high in fat and moderate in protein. Scientists are still studying why this works. The thought is that this approach alters the brain’s excitability by fueling the body through fats and proteins.
Our multidisciplinary care team includes a dietitian, who can guide you and your child on meal plans that can help control epilepsy. This team of specialists with different training and experiences will bring a range of viewpoints and opinions as part of formulating your child’s customized care plan.
Children who are treated with epilepsy diets are monitored at the Norton Children’s Ketogenic Diet Clinic and have regular checkups to monitor growth, bone health, electrolytes and other health metrics.