Treatment of a seizure
Specific treatment for a seizure will be determined by your child's doctor based on:
- Your child's age, overall health, and medical history
- Extent of the condition
- Type of seizure
- Your child's tolerance for specific medications, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
The goal of seizure management is to control, stop, or decrease the frequency of the seizures without interfering with the child's normal growth and development. The major goals of seizure management include the following:
- Proper identification of the type of seizure
- Using medication specific to the type of seizure
- Using the least amount of medication to achieve adequate control
- Maintaining good medicating levels
Treatment may include:
- Medications. There are many types of medications used to treat seizures and epilepsy. Medications are selected based on the type of seizure, age of the child, side effects, the cost of the medication, and the adherence with the use of the medication.Medications used at home are usually taken by mouth (as capsules, tablets, sprinkles, or syrup), but some can be given rectally (into the child's rectum). If the child is in the hospital with seizures, medication by injection or intravenous (IV) may be used. All medications can have side effects, although some children may not experience side effects. Discuss your child's medication side effects with his or her doctor. While your child is taking medications, different tests may be done to monitor the effectiveness of the medication. These tests may include the following:
Blood work. Frequent blood draws testing is usually required to check the level of the medication in the body. Based on this level, the doctor may increase or decrease the dose of the medication to achieve the desired level. This level is called the therapeutic level and is where the medication works most efficiently. Blood work may also be done to monitor the affects of medications on body organs.
Urine tests. These tests are performed to see how the child's body is responding to the medication.
Electroencephalogram (EEG). A procedure that records the brain's continuous, electrical activity by means of electrodes attached to the scalp. This test is done to monitor how the medication is helping the electrical problems in the brain.
Ketogenic diet. Certain children who are having problems with medications, or whose seizures are not being well-controlled, may be placed on a special diet called the ketogenic diet. This type of diet is low in carbohydrates and high in protein and fat.
Additional treatment options:
Vagus nerve stimulation (VNS). Some children, whose seizures are not being well-controlled with seizure medications, may benefit from a procedure called vagus nerve stimulation (VNS). VNS is currently most commonly used for children over the age of 12 who have partial seizures that are not controlled by other methods. VNS attempts to control seizures by sending small pulses of energy to the brain from the vagus nerve, which is a large nerve in the neck. This is done by surgically placing a small battery into the chest wall. Small wires are then attached to the battery and placed under the skin and around the vagus nerve. The battery is then programmed to send energy impulses every few minutes to the brain. When the child feels a seizure coming on, he or she may activate the impulses by holding a small magnet over the battery. In many people, this will help to stop the seizure. There are some side of the effects that may occur with the use of VNS. These may include, but are not limited to, the following:
Epilepsy Surgery. Another treatment option for seizures is surgery. Surgery may be considered in a child who:
Has seizures that are unable to be controlled with medications
Has seizures that always start in one area of the brain
Has a seizure in a part of the brain that can be removed without disrupting important behaviors such as speech, memory, or vision
Surgery for epilepsy and seizures is a very complicated surgery performed by a specialized surgical team. The operation may remove the part of the brain where the seizures are occurring, or, sometimes, the surgery helps to stop the spread of the bad electrical currents through the brain. A child may be awake during the surgery. The brain itself does not feel pain. With the child awake and able to follow commands, the surgeons are better able to make sure that important areas of the brain are not damaged. Surgery is not an option for everyone with seizures. Discuss this with your child's doctor for more information.
A ketogenic diet is a high-fat, adequate-protein, and very-low-carbohydrate diet which has been found to help many children whose seizures are not well-controlled by anti-seizure medications.
Vagal Nerve Stimulation (VNS) is an alternative for children whose seizures are not well-controlled with medications and who are not candidates for a brain operation to eliminate seizures.
The Neurobehavior Program is a subspecialty service of Children’s Center for Neuroscience and Behavioral Medicine, which focuses upon evaluation and management of behavioral effects associated with neurologic illness. Diseases emphasized include epilepsy, movement disorders, intellectual or developmental disabilities, migraines, and other complex neurologic and medical conditions.
To treat your child’s epilepsy, our program offers a complete range of individualized care plans – from minimally invasive surgery to dietary therapies. Learn more about our treatment options and how to schedule an appointment.
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.
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