Epilepsy Treatments for Children

Anti-Seizure Medicines to Epilepsy Surgery

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A wide range of treatments is available to help control your child’s seizures, and even, for some, to be seizure-free. If your child’s seizures cannot be controlled by medication, an epilepsy procedure is often the next step. As experts in treating children with epilepsy, our pediatric epileptologists work closely with your child to determine where the seizures originate from, which medications are effective, and when more advanced treatment is appropriate. Our goal is always to achieve the best possible outcome for your child.

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Non-Surgical Treatment Options

Anti-Seizure Epilepsy Medication

There are many anti-seizure medications available and new, effective medicines continue to become available. Our pediatric epileptologists are experienced using all types of anti-seizure medications. We know that a drug that helps one child may not be effective for another. That’s why our doctors work closely with you to determine which drugs may be most safe and effective for your child.

Minimizing Drug Interactions

In many cases, multiple medications may be necessary to control your child’s seizures. In these situations, we work to minimize drug interactions and find the best medication combinations for your child.

Clinical Trial Access

Our pediatric epilepsy experts participate in many clinical trials which may give your child access to therapies that are not widely available. This can be beneficial to your child when effective treatment options are limited.

Ketogenic Diet

A diet very low in carbohydrates and high in fat can be very effective in achieving seizure freedom or significant seizure reduction in some children, even those who have failed many prior medications. For some children, diet can be as effective as or even more effective than medication in controlling seizures. A pediatric epileptologist, nutritionist and nurse coordinator will work together to manage your child’s diet and epilepsy medications.

Personalized Medicine

We are one of the few epilepsy centers to offer “precision medicine,” a new, personalized approach that combines the sciences of drugs and genetics to develop medications that specifically target your child’s individual chemistry.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Brain Surgery for Epilepsy

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 to 80% 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% of children.

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Implantable Devices

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 deep brain. 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.

Level 4 Epilepsy Center

As a Level 4 Epilepsy Center, Duke Health provides the highest level of diagnosis, medical and surgical treatments for children with epilepsy. It is one of the reasons why Duke Children’s is nationally ranked in pediatric neurology and pediatric neurosurgery by U.S. News & World Report for 2020-2021.

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Epilepsy in Children

Reviewed: 02/21/2020