Epilepsy Program

Our team approach to care

The Epilepsy Program at Boston Children’s brings together a diverse array of specialists care for children with epilepsy and seizures. That means that your child can see all of his epilepsy medical providers in one place. The interdisciplinary nature of our team also means that we will consider every treatment possibility for your child, and we closely coordinate our treatment plans. See the Meet our team tab to learn more about the different people who work together to care for our patients.

In some cases, a child’s epilepsy is caused by an underlying disease, injury or brain development disorder. If that is the case, we closely coordinate our care with other groups at Boston Children’s who specialize in treating that condition.

You are an essential part of the care team. Ultimately, all decisions about your child’s care are made by you, after you thoroughly discuss the options with our doctors.

Evaluation  

To learn about your child’s seizures and to plan treatment, we may perform a number of specialized tests. Our laboratory performs about 5,000 electroencephalograms (EEGs)each year, making us an exceptionally experienced pediatric EEG facility. We evaluate children of all ages and abilities, from premature infants to adolescents, and our technologists provide skilled, compassionate care for each child.

The tests we perform include many different types of EEGs and evoked potentials (EPs). You can find detailed information on these tests at the links given here.

Many tests are performed on an outpatient basis. In certain cases, such as planning for surgery, children are admitted to our long-term monitoring (LTM) unit so that we can understand their seizures as precisely as possible.

You can read more detailed information on the diagnostic strategies we use on our Epilepsy page.

Treatment

Our team works together to develop a treatment plan that is right for your child and family. Our goal is to help your child live a seizure-free, fulfilling life and to minimize the side-effects of treatment. We may use several different strategies:

• Anti-seizure medicines are the most commonly prescribed therapy for seizures. The use of medicines is also called pharmacological management.
•  We may also prescribe the ketogenic diet, a highly specialized high-fat, low-carbohydrate diet that helps the body produce its own natural anticonvulsants.

When seizures don’t respond to medication or the ketogenic diet, our specialists may recommend surgical therapies. This generally involves performing brain surgery to remove the brain tissue where the epileptic seizures start or to prevent their spread.

Our surgeons also use vagal nerve stimulation (VNS), in which they implant a small pacemaker-like device to reduce seizures. Boston Children’s was one of the first hospitals to test VNS in children and has been using it regularly since the mid-1990s. We have performed more than 500 VNS operations, making us one of the most experienced pediatric VNS centers.

We use advanced pre-surgical tests to carefully plan all surgeries. In addition, our pediatric neurosurgery teams perform brain activity tests and imaging tests during surgery to help guide them. These technologies enable us to perform the most precise surgeries possible.

A child who is admitted to the hospital for evaluation or surgery comes to a unit that is exclusively devoted to children undergoing neurology and neurosurgery care and is staffed by specially trained and experienced nurses. You always have the option to stay with your child while she is in the hospital. Her doctor will visit personally each day, providing ample opportunity for you to talk with him.

The Epilepsy Surgery Conference takes place every week to carefully consider any surgery we are planning. The conference is attended by a wide array of people: neurologists, neurosurgeons, neuropsychologists, neuropharmacologists, nurses, social workers and others. Together we discuss all aspects of your child’s case; we will only recommend surgery if we believe it is the very best treatment option for your child.

You can read more detailed information on all aspects of treatment on our Epilepsy page.