Epilepsy - Comprehensive Pediatric Epilepsy Program (CPEP)
Whether your child had one seizure or is diagnosed with epilepsy, finding a pediatric specialist is an important step in getting quality care and support for your child and family.
The Children’s National epilepsy team has more than 8,000 visits each year, helping patients with a full range of concerns — new onset seizures, complex partial seizures, infantile spasms, chronic epilepsy, and intractable (hard-to-control) epilepsy.
Medical Director William Gaillard, MD, is an internationally recognized expert in pediatric epilepsy and imaging, and helped pioneer brain mapping with functional MRI (magnetic resonance imaging) for children. Dr. Gaillard researches the impact of seizures on language, cognitive, behavioral, and emotional development for young patients.
The programs other dedicated specialists include:
- Nurse practitioners
- Pediatric epileptologists (neurologists with special training and expertise in epilepsy and clinical neurophysiology)
- Social workers
Our team takes a comprehensive approach to treating patients, focusing on all aspects of care including cognitive, behavioral, and psychiatric evaluation and support. We address the associated complications of difficult-to-control epilepsy, including the accompanying social, educational, and emotional issues.
When surgery is recommend for a condition such as intractable epilepsy, the epilepsy team works closely with the neurosurgery team
to provide expert care.
Specialized clinics and programs provide focused treatment for patients with complex needs and chronic conditions:
A ketogenic diet, which controls the amount of carbohydrates, protein and calories, and instead focuses on foods rich in fats, is found to help many children having problems with seizure medications or whose seizures are not well controlled.
In some children, the diet is combined with standard anticonvulsant medications. While the actual mechanism of the ketogenic diet's effectiveness against seizures is unknown, many children on the diet are able to have their epilepsy medication dose lowered, decreasing unwanted medication side effects.
Because this is a medical diet, children's diets must be supervised by a medical team who can anticipate and manage possible nutritional deficits or other side effects. An interdisciplinary team of neurologists, nutritionists, a nurse practitioner, and a social worker help children and their families establish and maintain the diet, and learn how to incorporate the diet into daily living.
The team closely monitors the condition of children on the diet and sees them several times throughout the year. Conditions treated by the Ketogenic Diet Team include:
- Lennox Gastaut syndrome
- Glucose transporter type-1 deficiency
- Pyruvate dehydrogenase deficiency
Children’s National has one of the largest and one of the few new onset epilepsy programs in the country, treating nearly 400 children with newly-diagnosed seizures each year.
Child neurologists and epileptologists evaluate your child on arrival to our clinic. In addition to seminars led by our epileptologists, social worker, and nurse practitioner, the clinic offers an innovative educational program—the only one of its kind in the nation—to educate you and other parents about epilepsy, medications, and seizure management. We provide you with supplies, information, and resource materials to assist you in managing your child's care.
The newly diagnosed seizure clinic also facilitates the partnership between you and your child's doctor, and creates opportunities for you to meet and talk with other parents of children with epilepsy.
At Children’s National, one of our goals is to help our patients lead lives that are as close to normal as possible. Through the Brainy Camps Association, Children’s National sponsors and staffs Camp Great Rock, a week-long summer camp exclusively for children with epilepsy between the ages of 7 and 16. The camp teaches patients how to live with and manage their chronic illness, and – just as important – builds confidence, independence, and self-esteem, and lets everyone enjoy the summer camp experience.
Surgical treatment may be necessary for intractable epilepsy, when a child has numerous seizures that cannot be controlled by medications or other therapies. Surgery offers the best chance to live seizure-free for many children with hard-to-control epilepsy.
Children’s multidisciplinary epilepsy team of neurologists, neuroradiologists, and neurosurgeons determines the most appropriate approach for your child. Our team performs an average of 40 surgeries every year with excellent outcomes.
Because epilepsy is a chronic condition, Children’s National and Georgetown University Hospital, established the Transition Clinic to help ensure your child receives seamless care as they become young adults.
- Diagnostic evaluations for epilepsy and related disorders
- Evaluations for seizures, convulsions, and epilepsy
- Inpatient video EEG monitoring
- Management of epilepsy and refractory epilepsy
- Outpatient electroencephalograms (EEG)
- Pre-surgical evaluation of epilepsy
- Second opinions or management consultations for epilepsy
- Vagal nerve stimulator placement and management
- Surgical management of refractory epilepsy
- Assistance with epilepsy management prior to or during pregnancy
- Evaluation for potential study participation
Children whose seizures are not well-controlled with medications may benefit from a procedure called vagal nerve stimulation (VNS). VNS attempts to control seizures by sending small pulses of current to the brain from the vagus nerve, a large nerve in the neck.
A neurosurgeon places a small battery into the child’s chest wall. Small wires are attached to the battery and placed under the skin and around the vagus nerve. The battery is programmed to send impulses every few minutes to the brain. When the child feels a seizure coming on, he or she activates the impulses by holding a small magnet over the battery. For many patients, this can help stop a seizure.
The program follows approximately 70 patients each year, monitoring patients receiving VNS therapy for epilepsy and collecting data on VNS effectiveness.
The VNS procedure is performed at Children's National, with access to related services before and after surgery in the Neurology clinic at Children's National and at the Children’s regional outpatient center in Fairfax, Va. Patients and families may visit either site for pre-operative appointments to learn about the VNS, and follow-up appointments for VNS programming and monitoring after surgery.
- Departments & Programs - Children's National Medical Center
In addition to ongoing epilepsy research at the Children’s Research Institute, Children’s National has close working relationships with several institutes and organizations for research and clinical trials. Children’s National and the following partners have shared goals to improve diagnosis, treatment, and outcomes for epilepsy patients, and the ultimate goal to find a cure: