Epilepsy Treatment Options

Once your child’s seizure disorder is diagnosed as epilepsy, the specialists at Children’s Hospital’s Brain Care Institute will determine and discuss treatment options based on a number of factors. Although seizure medicines are typically prescribed as the first-line treatment, your child’s condition may call for other treatments, such as a Vagus Nerve Stimulation (VNS) implant or a ketogenic diet. Often more than one treatment is called for, and your child’s condition will be monitored closely for signs of improvement.

Seizure Medicines

Doctors typically begin with the least-invasive treatment, anti-epilepsy drugs (AEDs), also called anti-seizure drugs. The choice of which drug to prescribe depends on the type of seizure your child is having. Your child’s condition will be monitored for any improvement, as well as any side effects the drugs may cause. It may take some time to find the right drug and the right dose for your child.

Ketogenic Diet

The ketogenic diet is high in fats and proteins and restricts the intake of carbohydrates. This diet makes the body burn fat for energy. Once the diet is fine-tuned and tailored for each child, about a third of children become seizure-free and another third show marked improvement. 

For children who can’t tolerate the food or find the diet too restrictive, a modified Atkins™ diet may be prescribed.

Vagus Nerve Stimulator (VNS) Implantation

VNS is used when epilepsy surgery is not feasible, either because your child is too young or because the area of the brain where seizures originate is too close to important brain functions. This treatment uses short bursts of electrical energy that are directed into the brain through the vagus nerve, a large nerve in the neck. The device is a small pacemaker-like generator implanted into the chest wall. VNS can be activated by a patient or parent to stop seizures just as they are beginning.

Epilepsy Surgery

If your child’s seizures are intractable, which means they do not respond to medication, your doctor will determine if epilepsy surgery is an option. Using neuroimaging, such as MRI, MEG, and SPECT, as well as EEG monitoring, epilepsy specialists will attempt to isolate the area of the brain where the seizure originates. They will then evaluate to map the brain functions around the seizure site. This epilepsy focus mapping helps determine if epilepsy surgery is possible without damaging important functions of the brain, such as speech, memory, and vision.

Learn more about Child Neurology and the Epilepsy Foundation of Western/Central PA.