Epilepsy

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Neurosurgery Team

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Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, provides a comprehensive, multidisciplinary approach to treating epilepsy and seizures in infants, children and teens.

Our board-certified and fellowship-trained team of neurologists and neurosurgeons uses state-of-the-art diagnostic tools to understand your child’s seizures and epilepsy type. Our epilepsy specialists use their skills and experience to create customized treatment plans that minimize side effects, so your child can get back to being a kid again.

The Norton Children’s Hospital Comprehensive Epilepsy Center is a Level 4 epilepsy center, the highest rating available from the National Association of Epilepsy Centers. Norton Children’s Hospital has held this designation since 2013.

Diagnosing and Treating Epilepsy

Children can experience many different types of seizures and epilepsy conditions/syndromes. Epilepsy can begin at any age, even in infancy.

When your child experiences a seizure for the first time, it can be frightening. Specialists can help discover what may have caused the seizure and begin treatment that’s tailored to your child. Information will be collected, including when the seizure started, what happens during a seizure, medicines being used and other medical conditions.

A complete evaluation will be ordered to locate the exact spot in the brain causing the seizure activity. Some epilepsy conditions are easily treated and managed by medicines, and others may be severe and require surgery. Our physicians will work with you and your child to develop a treatment plan that may lead to your child becoming seizure-free.

Phase I Evaluations and Tests

Electroencephalography (EEG): This recording of brain waves with electrical receivers on the surface of the skin helps determine the type of seizure.

Magnetoencephalography (MEG): Similar to an EEG, this test measures brain waves using magnets.

Magnetic resonance imaging (MRI): This technology uses powerful magnets to scan and take a picture of the brain to identify brain structure abnormalities.

Functional Testing

Functional MRI: The patient listens, thinks and moves as directed during an MRI to show which part of the brain is using more oxygen-rich blood.

Positron emission tomography (PET): This type of scan uses computed tomography (CT) to measure how much sugar a patient’s brain is using.

Single photon emission computed tomography (SPECT): This scan uses a CT machine to measure blood flow to the brain.

Neuropsychological evaluation: A neuropsychologist assesses the patient to help understand the link between the brain and behaviors.

Wada test: This minimally invasive test is used to determine which side of the brain controls language and memory functions.

The child’s test results are reviewed during a weekly epilepsy surgery team conference. Based on the results, recommendations for further testing or surgical treatment are made.

Phase II Evaluations if Surgery Is Needed

Stereo EEG and electrocorticography (ECoG): These very detailed tests use electrodes in the brain to get information about deep seizures.

The child’s provider will discuss the surgery type, if needed, and corresponding recovery therapy. The Norton Children’s Ketogenic Diet Clinic may also be recommended after treatment.

Types of Epilepsy We Treat

  • Absence epilepsy: This type causes repeated seizures with brief lapses of consciousness. It usually begins in childhood or early teen years. These seizures cause undesired movement, such as rapid eye blinking or an arm moving wildly. Children also can have no symptoms other than feeling “out of it.” Seizures usually occur frequently and may make it difficult for a child to concentrate in school.
  • Benign focal childhood epilepsy: This type causes the muscles to stiffen and jerk. These seizures usually occur at night.
  • Childhood and juvenile absence epilepsy: This type of epilepsy can cause a blank stare, eye fluttering and slight muscle jerks.
  • Infantile spasms (West syndrome): This type causes muscle spasms that affect a child’s head, torso and limbs. It affects infants, usually appearing before 6 months of age.
  • Juvenile myoclonic epilepsy: This type causes jerking in the shoulders or arms.
  • Lennox-Gastaut syndrome: This type of epilepsy causes frequent seizures of different kinds, including atonic seizures. It can lead to sudden falls, called drop attacks, during a seizure.
  • Neocortical epilepsy: Seizures from this type of epilepsy start from the brain’s outer layer (cortex). They can be either focal or generalized. Focal seizures can cause an aura or a feeling that a seizure may happen. They may include strange sensations, visual hallucinations, emotional changes, muscle spasms, convulsions and a variety of other symptoms.
  • Rasmussen’s encephalitis: This autoimmune disorder causes inflammation in the brain. The inflammation is caused by white blood cells attacking the body’s tissues and cells. This condition can cause seizures that begin in early childhood.
  • Refractory epilepsy: This type, also called intractable epilepsy, is defined by seizures that cannot be controlled by two or more medications. Surgery, devices and dietary therapies provided by the Norton Children’s Ketogenic Diet Clinic may be treatment options.
  • Temporal lobe epilepsy: This is the most common type of epilepsy. Children with this type experience focal (partial) seizures.

Collaboration With UofL School of Medicine for Your Child’s Care

Our providers offer highly skilled care for your child. Norton Children’s Hospital serves as the primary pediatric teaching facility for the University of Louisville School of Medicine. These doctors are professors and active researchers helping to advance medical care through clinical research and education.

Why Norton Children’s Neuroscience Institute?

  • The Norton Children’s Hospital Comprehensive Epilepsy Center is a Level 4 epilepsy center, the highest rating available from the National Association of Epilepsy Centers. Norton Children’s Hospital has held this designation since 2013.
  • We are the first in Kentucky and among the first in the nation to use neurostimulation in a pediatric patient.
  • Regional neurology care is available for children across Kentucky and Southern Indiana. We travel to clinics in Bowling Green, Campbellsville, Corbin, Elizabethtown, Frankfort, Owensboro and Paducah, Kentucky; and Evansville, Indiana. We also perform a number of telemedicine visits each week.
  • Our specialists use state-of-the-art technology to treat epilepsy, uncontrollable seizures and deep brain tumors in children who, in the past, would not be candidates for surgery, including:
    • Visualase: Technology that allows neurosurgeons to perform MRI-guided laser ablation surgery. Fewer than two dozen pediatric hospitals in the U.S. offer this technology.
    • Surgical Theater: Virtual reality technology that creates an immersive 3D view of a patient’s brain, allowing neurosurgeons, the patient and family to see inside the skull and brain to get a greater understanding of the condition and impact of potential procedures. Norton Children’s Hospital is the first hospital in the region to use this technology.
  • We offer dedicated multidisciplinary clinics for brain tumors, traumatic brain injuries, spina bifida, craniofacial injuries and disorders, epilepsy, muscular dystrophy, spasticity, headache and migraine, autism, neurogenetic syndromes and neurocutaneous disorders.
  • Our multidisciplinary craniofacial program was the first established in the Midwest.
  • We offer a neuropsychology program that specializes in the evaluation of children and teens with a variety of neurological, neurodevelopmental and medical conditions, including brain tumors and epilepsy.
  • Outpatient neurology facilities in downtown Louisville are equipped with in-office electroencephalography (EEG) capabilities and laboratory services in the same building, creating a streamlined, family-centered environment.
  • We offer the region’s first clinic to treat children with immune-mediated neurological disorders.

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