About 2/3 children with epilepsy take one or more medications for seizure control and respond positively. These treatments are often called anticonvulsants or anti-epileptic drugs (AEDs), and are the most common way of treating the disorder.
It is important to know your child’s medications and doses. It is helpful to keep a list of medications tried in the past and a brief reason why the medication was discontinued. You should alert your child’s doctor if your child has a known or suspected allergy to a medication.
The goal of seizure therapy is to eliminate seizures without causing side effects, but sometimes this is not possible. Your child’s care team should assist in weighing the benefits of medication to any drawbacks.
There are several special diets which may be useful in controlling seizures. Each of the diets are low in carbohydrates and most have a higher fat content. The classic ketogenic diet consists of large amounts of fat with minimal carbohydrates and just enough protein for growth, and should only be attempted under the direct supervision of a qualified health professional. You can find more information on this treatment option here.
Surgery to reduce or control seizures is a well-established option for children and adults with epilepsy when medical therapies have failed. Recent studies show that earlier surgical evaluation and intervention may increase the chances for a better overall outcome.
Surgery may be considered when:
- Medications have failed to control seizures
- The seizures start from one part of the brain
- There is a localized lesion in the brain
Surgical evaluation is an extensive process. A multidisciplinary team will first ensure that surgery will not be harmful to the patient’s cognitive skills, such as communicating or remembering things. The first step is inpatient EEG-Video monitoring to identify where seizures originate in the brain. Additional testing, such as a brain MRI, then helps evaluate brain anatomy. The decision to proceed with a further surgical evaluation and/or intervention is made after each phase of the work-up and a comprehensive review of the findings by the epilepsy team.
The vagal nerve stimulator is an electronic device that may diminish seizures by sending electrical impulses to the brain. It is typically used when a child has not responded well to medication. The device is surgically implanted under the skin of the chest, which is typically a single day procedure. Once the stimulator is placed, the patient or a caregiver can swipe a magnet over the area of the implant at the onset of a seizure to potentially shorten the event.