Medication therapy—Medications are the first line of treatment for epilepsy. Approximately 70% of patients with epilepsy have good seizure control if they take medications as instructed. These medications are called antiepileptic drugs (AEDs). There are many AEDs used to treat epilepsy and good seizure control can be achieved typically with one or two combination of drugs.
The Ketogenic Diet—The Ketogenic diet is a treatment option for children whose seizures are not responsive to medications. The strict diet forces the body to use fat for its energy source rather than carbohydrates, thereby inducing ketoacidosis. The ketosis functions as an AED. This treatment requires commitment and sticking to the diet may be difficult. This diet must be monitored by your medical team.
If the medications do not work or your child has too many side effects there are other treatment options that are FDA approved.
Epilepsy Surgery Options
All children with poorly controlled seizures are not candidates for epilepsy surgery. Only those children in whom seizures are coming from one side of the brain will likely achieve seizure control. The possibility of surgical treatment begins with a discussion with the patient and family. Then a comprehensive presurgical evaluation is performed which may require multiple tests. There are several surgical options for the treatment of epilepsy and once the presurgical evaluation is complete the approach is tailored to the individual.
Please be aware that during the pre surgical evaluation process you will be required to bring your child to the hospital for all scheduled tests.
While we will attempt to get a pre approval for each of the tests we order, we strongly recommend that you contact your insurance company to let them know what is going on and to learn about your specific policy, co pays and financial obligations upfront.
Types of Epilepsy Surgery
Resective/Resection Procedures—surgical removal of seizure prone area/tissue of brain
Palliative Procedures—procedures to restrict the spread of seizures
Post operative care and follow up after epilepsy surgery- We continue to closely follow your child for many years after surgery through clinic appointments, tests, EEG, MRI and admissions to EMU for monitoring. It is vital that your child continue taking the medications your doctor prescribes until your doctor tells you otherwise, which may be for multiple years post surgery/last seizure.
Epilepsy surgery may be an option if the patient has all of the following:
Most experts recommend that a patient who continues to have seizures after trials of 2 or 3 different medications should have an evaluation at a comprehensive epilepsy treatment program.