Epilepsy Treatments for Children

When children with epilepsy have failed more than three different anti-seizure medications, a surgical procedure may be more effective in achieving freedom from seizures, or may significantly reduce the frequency and severity of the seizures. Our pediatric epileptologists identify children who are good candidates for epilepsy surgery. We work very closely with pediatric neurosurgeons (who have special training in epilepsy surgery) to ensure the best possible outcomes for your child.

Focal Cortical Resection

When imaging tests show the seizures originate in a specific part of the brain, resective epilepsy surgery, as this is often called, can remove that isolated area.  Because this procedure can often stop the seizures entirely, it is the preferred treatment when medication is ineffective. This epilepsy surgery can provide seizure freedom in 60-80 percent of children. These focal cortical resections can include resection of the epileptic focus in any lobe of the brain (temporal, frontal, partial, or occipital). It can also include resections involving parts of two lobes.  

Laser Ablation Surgery

Pediatric neurosurgeons use MRI imaging to guide the insertion of a thin laser that destroys brain lesions responsible for epilepsy and uncontrolled seizures. Because the surgery requires small incisions, your child will recover faster than with open brain surgery.

Corpus Callosotomy

When the specific origin of the seizure cannot be identified, this procedure removes a section of a band of tissue called the corpus callosum that sends messages between the two sides of the brain. This prevents seizures from spreading from one side of your child’s brain to the other. It is usually performed in people with drug-resistant seizures that cause falls and injuries.

Hemispherectomy

This procedure is recommended for children with very severe epilepsy caused by one hemisphere of the brain that is markedly malformed or injured. This procedure disconnects the parts of the brain that are causing the seizures and are not functioning as they should. It can resolve seizures in up to 80 percent of children.

Vagus Nerve Stimulation

VNS therapy is typically considered in children whose seizures cannot be controlled through medication or in whom resective epilepsy surgery is not a good option. A pacemaker-like device is implanted in the chest during an outpatient procedure. It controls seizures by sending electrical impulses to the vagus nerve, which then sends the impulses to the brain.  Your child can go home the same day.

Responsive Neurostimulation (RNS)

A device is implanted under the scalp that is connected to electrodes placed on the surface or into your child’s brain. This device can continuously “listen” for seizure activity coming from the specific brain region. If a seizure pattern is detected, it sends an electrical signal to stop the seizure. This device is FDA-approved for those ages 18 years and older and is used in people where a specific part of the brain is causing seizures but in whom focal resection may not be the best option because that brain region may be also responsible for movement, speech, or other important functions.

Deep Brain Stimulation (DBS)

This is a newer technology in which electrodes are implanted into a specific part of the thalamus (a deep brain structure). The electrodes are connected to a device implanted under the skin of the chest. The DBS sends a scheduled electrical signal to the deep brain structures. That has a calming, anti-seizure effect on the brain. This device is FDA-approved for people who are 18 years and older and is used when seizures come from many parts of the brain or in whom resective epilepsy surgery is not an option.