Treatments for Epilepsy In Children
Children with epilepsy are usually on medication for seizures. If your child's response is not satisfactory, surgery may be an option. It's possible to be scared about the prospect of brain surgery for your child. The treatment is reserved for very few. While surgery for epilepsy can be quite invasive, it is safer and more successful than ever.
In some cases of epilepsy, doctors can locate the specific part of the brain that is causing the seizures. A surgeon might be able remove the affected area without any complications.
In some cases where the origin of the seizures may not be clear, your doctor may suggest a surgical procedure using intracranial electrodes -- electrodes that are placed on the surface of or inside the brain -- to get more information. A surgeon will cut the skull open and then place electrodes embedded in plastic on the brain. After the electrodes are placed, they monitor your brain's electrical activity. This test may help determine the focal point of the seizures and allow you and the doctor to decide whether further surgery makes sense.
One common type of epilepsy surgery is a lobectomy, in which the focus of the seizures (where the seizures originate) is removed from a lobe of the brain. The most common type of lobectomy, a temporal lobectomy, stops or greatly improves seizures in up to 85% of people. Most patients will continue on seizure medication, although it will usually be a reduced amount compared to before the surgery.
Other types of surgery are used when the seizures can't be localized to a specific part of the brain. These include:
Multiple subpial transsection. In this surgery, cuts are made on the surface of the brain in the specific parts causing the seizures.
Corpus callosotomy. This surgery involves removing the connection between the brain's two hemispheres.
Both operations can prevent seizures from spreading.
Another procedure that involves the removal of up to half the brain's entire is called a hemispherectomy. These surgeries have greater risks, but they can make a huge difference for children with uncontrolled seizures and related disabilities.
The only option is surgery for severe epilepsy. Surgery won't work if epilepsy results from multiple lesions located on the brain.
It can be difficult to make the right decision about having surgery. Don't rush to make the decision. Unless there's a tumor that's causing the seizures, there's no special urgency. Find out more about surgery and the alternatives. You and your child should be completely confident about the procedure before you make a decision to go ahead with it.
Vagus Nerve Stimulation and Epilepsy (VNS).
VNS is a newer type of treatment for people with seizures who haven't had success with medication and are not candidates for epilepsy surgery. It's conceptually very similar to the pacemaker used for patients with heart disease. A VNS is a device that's about the size and shape of a quarter in the chest. You attach it to your vagus nerve by tiny wires underneath the skin. The nerve is a long, complex nerve that runs along the spine. It emits electrical pulses every few minutes.
Exactly why the device works isn't entirely clear, but these regular pulses of electricity help many people with epilepsy reduce the frequency or intensity of their seizures. A magnet can also be used to activate the device manually. It can be attached to your wrist or belt. If a person feels a seizure coming on, they can wave the magnet over the device to cause it to immediately deliver an electric charge. Parents could also use the magnet on their child after a seizure has begun.
VNS can cause hoarseness, and less often, discomfort. It can also change a person’s voice within a matter of seconds. It is often turned off by people before they sing or speak in public. Doctors can reprogram it in their office with a computer. The battery should last for six to eighteen years.
VNS doesn't cure epilepsy, but, like anti-seizure medicines, in most people it helps reduce symptoms. VNS is a method that allows a patient to continue taking medication but in smaller amounts.
Future of Epilepsy Treatment for Children
Although a cure is not yet possible, there is progress being made in the treatment of epilepsy. Experts predict that there will be success with epilepsy research if more money is available. There have been significant advances in technology that can be used to manage epilepsy, and in surgical evaluations.
The genetics of epilepsy has also seen promising results. Researchers are starting to discover how various types of the disorder are inherited. Eventually, a better understanding of genetics could lead to more targeted and more effective treatments for the different varieties of seizures.
Experts believe that the next major breakthrough in drug development will come from drugs specifically made for children. It's much more challenging to find drugs for children than it is for adults, so epilepsy sufferers end up with drugs made specifically for them. Scientists are now confirming the fact that children with epilepsy differ from adults. It is now possible to create drugs for children.