Below the Surface of Pediatric Epilepsy

A team approach treats all aspects of pediatric epilepsy, beyond just a single symptom.

Epilepsy is a neurological disease in which nerve signals in the brain are disrupted, often characterized by seizures. Beyond the surface, many other conditions and needs come along with epilepsy in children.

Accurate diagnosis is complicated but critical. Other conditions can mimic epilepsy and must be ruled out through critical analysis of the patient's history. A thorough understanding of the exact cause of the seizures can help inform the best individualized treatment.

Early diagnosis can help parents address seizures as well as identify and help other common conditions.

Comprehensive epilepsy care includes the treatment of issues associated with epilepsy that are below the surface, including learning disabilities, autism, attention deficit disorder, behavioral issues and depression.

These issues require treatment along with the epilepsy, which may include an individualized education plan, psychological evaluation and/or medication.

Everyday accommodations are also needed to address the epilepsy. Coaches, teachers and caretakers need action plans in case of seizure. Activities like swimming and climbing may need to be restricted or closely monitored.

Treatment should be tailored to the individual based on their specific seizure type and the underlying causes.

• Medication is the most common treatment, but potential side effects may need to be monitored.
• Ketogenic diet has shown a 50% or better reduction in seizures in 50% of pediatric cases, with 15% becoming seizure-free.
• Surgery is an option if the source of seizures is localized to a part of the brain that can safely be removed.
• Vagus nerve stimulation uses an implanted device to stimulate a nerve in the neck. It reduces seizures by >50% in half of patients.

Treat the child, not the disease. The goal is to balance the treatments for epilepsy with consideration for the accompanying conditions. This requires a coordinated team of experts across multiple disciplines.

A child's team may include:

• Neurologist
• Epilepsy nurse
• Neurosurgeon
• Radiologist
• Psychologist
• Social worker
• Behaviorist
• Recreational therapist
• Educational specialist
• Dietitian

Source: MayoClinic.org.