Refractory Epilepsy

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Neurosurgery Team

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Intractable epilepsy, also called refractory epilepsy, means your child’s seizures aren’t controlled by two or more medications. The fellowship-trained and board-certified epileptologists with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, are leaders in treating intractable epilepsy in children.

Our providers are at the leading edge using current anti-epileptic medications and are skilled in monitoring for side effects. We work to give your child as little medication as possible while optimizing quality of life.

Our multidisciplinary approach means we can arrange appointments with the specialists on your child’s care team to minimize the number of trips you need to make to the office. With specialists working as a team on your child’s intractable epilepsy, your child will benefit from viewpoints of physicians with a range of training and experience.

When medication doesn’t ease seizures, other options range from diet to surgery.

Our multidisciplinary team includes a dietitian who can guide you and your child on meal plans that can help control epilepsy. These include the ketogenic diet, modified Atkins diet and low glycemic index diet.

Children who are treated with epilepsy diets are monitored in our Ketogenic Clinic and have regular checkups to monitor growth, bone health, electrolytes and other health stats.

Considering Surgery for Intractable Epilepsy

Surgery may be an option for children with intractable epilepsy. Brain surgery typically is elective and can come with a range of risks and benefits depending on where in your child’s brain the seizures happen.

Surgery can be a difficult decision for a parent — weighing the chance of reducing or eliminating seizures against the risk of abnormal brain function.

We know you’ll be given a lot of information during your child’s office visit and you’ll have many questions. Our providers will give you a detailed packet of information with images of your child’s brain that explains where the seizures are happening and how they affect the brain. Our providers will clearly explain the potential risks and benefits and why your child’s neurosurgeon is recommending a particular approach.

Take your time. Study the information. Use it to get a second opinion. When you are ready to discuss options with a neurosurgeon, we’ll be here to answer any questions. If you decide you don’t want to move forward with surgery, we’ll continue working with your child to ease seizures.

To help you better understand what’s happening in your child’s brain, we use Surgical Theater technology that collects hundreds of images of your child’s brain and compiles them into a vivid 3D image. You and your child can explore the structures of their brain using virtual reality goggles. Prints of the images will be included in your information packet.

The Surgical Theater images also are used by neurosurgeons to get a better understanding of your child’s epilepsy and even rehearse surgery ahead of time.

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. This technology includes:
    • Visualase: Technology that allows neurosurgeons to perform magnetic resonance imaging (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.

Refractory epilepsy in children also is called intractable epilepsy or drug-resistant epilepsy. It means your child’s seizures aren’t controlled by two or more medications. The fellowship-trained and board-certified epileptologists with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, are leaders in treating refractory epilepsy in children.

Our leaders use advanced technology, like Surgical Theater which collects hundreds of images of your child’s brain and compiles them into a vivid 3D digital model. Neurosurgeons explore this 3D digital model to better understand of your child’s epilepsy and even rehearse surgery ahead of time. You and your child can also explore the structures of their brain using virtual reality goggles.

NAEC Level 4 Epilepsy Center

Our providers are also at the leading edge using current anti-epileptic medications and are skilled in monitoring for side effects. We work to give your child as little medication as possible while maintaining or improving quality of life.

It’s not uncommon that a child with refractory epilepsy needs to see several neurosciences specialists and other epilepsy care providers. To help families reduce the number of trips needed for appointments, our multidisciplinary care team can arrange multiple appointments on one date and at one location.

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.

A part of the plan can include the ketogenic diet, modified Atkins diet and low glycemic index diet. 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.

Surgery for Refractory Epilepsy in Children

Surgery may be an option for children with refractory epilepsy. Brain surgery typically is elective and can come with risks and benefits depending on where in your child’s brain the seizures happen.

Surgery can be a difficult decision for a parent — weighing the chance of reducing or eliminating seizures against the risk of abnormal brain function.

We know you’ll be given a lot of information during your child’s office visit and you’ll have many questions. Our refractory epilepsy care providers will give you a detailed packet of information with images of your child’s brain that explains where the seizures are happening and how they affect the brain. Our providers will clearly explain the potential risks and benefits, and why your child’s neurosurgeon is recommending a particular approach.

Take your time. Study the information. Use it in your research. When you are ready to discuss options with a neurosurgeon, we’ll be here to answer any questions. If you decide you don’t want to move forward with surgery, we’ll continue working with your child to ease their refractory epilepsy.

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. This technology includes:
    • Visualase: Technology that allows neurosurgeons to perform magnetic resonance imaging (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.

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