Epilepsy affects about 1% of children. It’s a complex condition, but with treatment, most children manage seizures and live without major disruptions to their everyday lives. However, for those with intractable epilepsy, also called refractory epilepsy, surgery may be the best way to eliminate seizures.

The board-certified and fellowship-trained neurosurgeons with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, perform more than 750 epilepsy surgeries every year with precision, expertise and skill.

Thomas M. Moriarty, M.D., Ph.D., leads the team of experienced neurosurgeons. Our physicians have the sophisticated tools and skills to give you and your child a precise diagnosis and a customized treatment plan for epilepsy that minimizes risk of side effects, so your child can get back to being a kid.

State-of-the-Art Neurosurgery Technology

Norton Children’s Hospital is the only hospital in Kentucky equipped to perform minimally invasive neurosurgery in children who, in the past, would not have been candidates for surgery.

Using Visualase technology, Norton Children’s neurosurgeons thread a tiny instrument about the width of a piece of spaghetti into the patient’s brain. Real-time MRI guides the tool along a precise path, and once it reaches the source of the child’s seizures, a small amount of heat eliminates the lesion. The procedure usually takes only minutes, and most patients go home the following day.

Surgery previously wasn’t an option for lesions deep in the brain, because damage to surrounding tissue would have been too great.

Fewer than two dozen pediatric hospitals in the U.S. offer this technology.

Norton Children’s Neuroscience Institute now has Surgical Theater virtual reality (VR) technology that creates an immersive 3D view of a child’s brain. This allows neurosurgeons, patients and families to see inside the child’s skull and brain to get a greater understanding of the condition and potential surgical procedures. Norton Children’s Hospital is the first hospital in the region to use this technology.

Functional Hemispherectomy and Corpus Callosotomy

When larger parts of the brain are involved, team members can perform procedures such as a functional hemispherectomy or corpus callosotomy.

In a functional hemispherectomy, the surgeon removes the part of the brain where seizures start. In a corpus callostomy, to prevent a seizure from spreading from one side of the brain to the other, the surgeon may cut the corpus callosum, which sends signals from one hemisphere to the other.

Vagus Nerve Stimulation

Norton Children’s neurosurgeons also use vagus nerve stimulation (VNS), which can reduce the frequency of seizures. The surgeon places the stimulator under the skin on the left side of the chest. Electrodes connect to the vagus nerve on the left side of the neck.

The VNS device sends regular pulses of electrical energy to the brain to prevent seizures. The pulses are so mild the patient typically doesn’t notice.

VNS devices are U.S. Food and Drug Administration-approved for children ages 4 and older.

Responsive Neurostimulation

Responsive neurostimulation (RNS) involves placement of a battery-powered device within the skull and one to two electrodes in areas of the brain. When the device detects unusual electrical activity that could lead to a seizure, it sends a small pulse within milliseconds to help brainwaves return to normal. The stimulation doesn’t cause pain or unusual feelings.

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.
• The specialists with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, 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/migraine, autism and neurocutaneous disorders.
• Our multidisciplinary craniofacial program was the first established in the Midwest.
• We offer a neurogenetics clinic to evaluate and treat children with neurogenetic syndromes.
• We have 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.