The goal of treatment is to control, stop or reduce how often seizures occur. Treatment is most often done with medicine. Many types of medicines are used to treat seizures and epilepsy. Your child’s health care provider will need to identify the type of seizure your child is having. Medicines are selected based on the type of seizure, age of the child, side effects, cost and ease of use. Medicines used at home are usually taken by mouth as capsules, tablets, sprinkles or syrup. Some medicines can be given into the rectum or in the nose. If your child is in the hospital with seizures, medicine may be given by injection or intravenously by vein (IV).
It is important to give your child medicine on time and as prescribed. The dose may need to be adjusted for the best seizure control. All medicines can have side effects. Talk with your child’s health care provider about possible side effects. If your child has side effects, talk to the health care provider. Do not stop giving medicine to your child. This can cause more or worse seizures.
While your child is taking medicine, he or she may need tests to see how well the medicine is working. Your child may have:
- Blood tests. Your child may need blood tests often to check the level of medicine in his or her body. Based on this level, the health care provider may change the dose of medicine. Your child may also have blood tests to check the effects of the medicine on his or her other organs.
- EEG. An EEG is a procedure that records the brain's electrical activity. This is done by attaching electrodes to the scalp. This test is done to see how medicine is helping the electrical problems in your child’s brain.
Your child may not need medicine for life. Some children are taken off medicine if they have had no seizures for 1 to 2 years. This will be determined by your child's health care provider.
If medicine doesn’t work well enough for your child to control seizures or your child has problems with side effects, the health care provider may advise other types of treatment. Your child may be treated with any of the below:
- A ketogenic diet. This type of diet is very high in fat, and very low in carbohydrates. Enough protein is included to help promote growth. The diet causes the body to make ketones. These are chemicals made from the breakdown of body fat. The brain and heart work normally with ketones as an energy source. This special diet must be strictly followed. Too many carbohydrates can stop ketosis. Researchers aren’t sure why the diet works. But some children become seizure-free when put on the diet. The diet doesn’t work for every child.
- Vagus nerve stimulator (VNS). This treatment sends small pulses of energy to the brain from one of the vagus nerves. This is a pair of large nerves in the neck. If your child is age 12 or older and has partial seizures that are not controlled well with medicine, VNS may be an option. VNS 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 one of the vagus nerves. The battery is then programmed to send energy impulses every few minutes to the brain. When your child feels a seizure coming on, he or she may activate the impulses by holding a small magnet over the battery. In many cases, this will help to stop the seizure. VNS can have side effects such as hoarse voice, pain in the throat or change in voice.
Surgery may be done to remove the part of the brain where the seizures are occurring. Or the surgery helps to stop the spread of the bad electrical currents through the brain. Surgery may be an option if your child’s seizures are hard to control and always start in one part of the brain that doesn’t affect speech, memory or vision. Surgery for epilepsy seizures is very complex. It is done by a specialized surgical team. Your child may be awake during the surgery. The brain itself does not feel pain. If your child is awake and able to follow commands, the surgeons are better able to check areas of his or her brain during the procedure. Surgery is not an option for everyone with seizures.