Helping Children and Teens with Seizures
Having a seizure or trying to help during a seizure can be a frightening experience. At the Carolinas Pediatric Epilepsy Program, our team of experts excels in diagnosing the cause of seizures and in helping the family navigate through complex decisions about treatment.
The Carolinas Pediatric Epilepsy Program cares for patients who have had seizures or who have epilepsy from birth through young adulthood. We see patients at several locations throughout the Charlotte metropolitan area, including Jeff Gordon Children's Hospital in Concord and Levine Children's Hospital in central Charlotte.
- Facilities on the campus of Levine Children's Hospital prioritize management of more complex problems with seizures, through interventions including surgery. This location also offers a Level IV Epilepsy Monitoring Unit, the highest designation offered by the National Association of Epilepsy Centers. In addition to outstanding pediatric and adult neurological and neurosurgical expertise, extensive resources in neuroimaging, neuropsychology and neurological rehabilitation are available.
- Facilities at Jeff Gordon Children's Hospital include North Carolina's only dedicated pediatric Level III Epilepsy Monitoring Unit. In addition, the Carolinas Pediatric Epilepsy Program offers its ketogenic diet program, active for almost two decades, at this location.
Finding the Cause of the Problem
During your first visit, our experts carefully review the circumstances around seizure occurrence, focusing especially on any family history or developmental and behavioral issues that may help us better understand the scope of the issue. We perform a thorough physical and neurological examination, and, if appropriate, we arrange for further diagnostic testing to look at brain function or structure.
Tests used in diagnosis include:
- Electroencephalogram (EEG) - A painless test that allows the team to measure electrical activity of the brain and identify any potential source of electrical dysfunction that may cause seizures.
- Magnetic resonance imaging (MRI) - A test that allows our experts, without radiation, to create a detailed picture of brain structure and identify subtle regions of injury or malformation that may be a source of seizure activity. Smaller, active children may benefit from sedation for this test. Jeff Gordon Children's Hospital offers MRI-compatible goggles that allow children to watch a movie while undergoing this test.
- Extended video electroenecephalogram (VEEG) - A study performed over one or more days in the hospital, allowing us to record – both visually and electrically – one or more seizures.
Our expert team reviews and explains the results of initial comprehensive evaluation, making recommendations for appropriate management or more detailed genetic or neuropsychological assessment. Successful management is a cooperative effort between pediatric neurologists who are experts in the knowledge of epilepsy and family members who are experts in the knowledge of their child.
Managing Seizures in Your Child
Our initial effort is working with the family to find the best management strategy for the child. Not all seizures require medication, in fact, some seizures do not respond well to medication. Common options the team may discuss with families include:
- Preventive medication - Anti-seizure medications given once or twice daily can be an effective and efficient way to reduce the likelihood of seizure recurrence. Based upon the seizure type and the profile of your child, our experts balance the benefits and potential concerns in recommending and monitoring the best medication for your child.
- Emergency medication - When seizures are infrequent and daily medication is not necessary, our staff may recommend interventions to interrupt a seizure in progress or to prevent a flurry of seizures.
- Dietary management - For almost a century, the ketogenic diet has been recognized as a highly effective way to reduce or stop seizures. This high-fat, low-carbohydrate, low-protein diet induces the brain to operate on a different fuel and requires specialized guidance with meticulous monitoring. Less restrictive options include the Modified Atkins Diet for Epilepsy (MADE) or the Low Glycemic Index Diet (LGID).
- Electrical stimulation - Because the brain is very responsive to external stimulation, devices like the Vagus Nerve Stimulator (VNS) can be used to reduce seizure activity. This pacemaker is a small device implanted under the skin of the chest and connected to a nerve in the neck. After simple “under the skin” surgery, the device is externally programmed over several months, to find the optimal setting for painless seizure control.
- Laser ablation - In children whose seizures arise from highly localized problem areas in which the brain is malformed or has been injured, NeuroBlate uses MRI-guided fiber-optic light to remove damaged tissue.
- Resective surgery - If seizures arise from larger regions of brain that are not involved in normal brain activity, our skilled epilepsy surgeons can physically remove or electrically disconnect the regions that do nothing but cause seizures. Careful coordination with precise imaging and, when appropriate, electrical mapping of brain function is central to the team's approach.
Because seizures occur as a result of momentary brain dysfunction, team members of the Carolinas Pediatric Epilepsy Program take a holistic look at all brain and neurologic function. In addition to protecting children from unnecessary seizures, our goal is to identify and address developmental, behavioral and psychological issues that may be part of the bigger picture. When appropriate, the pediatric epilepsy team coordinates with experts from other specialties to address all of a patient's needs.
Looking into the Future
A significant number of infants and children will outgrow seizures, although that does not necessarily mean their paths will be simple. Our aim in partnering with you over months or years is to identify what challenges your child is likely to encounter and how – together – we might best meet future needs. The experts at the Carolinas Pediatric Epilepsy Program provide the most current information and the most successful strategies for helping you care for your child.