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During your first visit in the Epilepsy Center at Boston Children’s Hospital, you and your child will meet with a neurologist. He or she will review your child’s medical history, perform a complete physical exam, and may order some testing.

How we diagnose epilepsy

At Boston Children’s we use a high-definition electroencephalogram (EEG) to get a more detailed picture of brain activity. Our EEG technologists specialize in working with children and our clinicians are experts in interpreting the results. This expertise can make a big difference in making a correct diagnosis.

We may also order other tests to help confirm the diagnosis, including evoked potentials and imaging tests, such as a CT, MRI, or PET scan. Because our clinicians and radiologists have extensive experience at interpreting the results of these tests, they can often see things that others might not find.

Our innovations in treatment

Although medication is still the first line of treatment for epilepsy, we also use recent research to further individualize medical treatment to help control seizures.

Some of the innovative treatments we offer include:

  • Chronotherapy: This involves carefully timing treatment to the times when seizures most often happen. Tobias Loddenkemper, MD, a neurologist with the Boston Children’s Hospital Epilepsy Center, finds chronotherapy often helps medications work better to treat seizures.
  • Genetically tailored treatments: The Boston Children’s Epilepsy Genetics Program uses DNA sequencing to discover previously unknown genetic causes of seizures. Some of these disrupt brain biochemistry in a way that can be targeted with drugs.
  • Pharmacogenomics: We’re studying how genetic differences in metabolism affect children’s responses to medications. This information helps us choose the optimal treatment for each child.
  • Ketogenic diet: Our Ketogenic Diet Clinic is run by nutritionists who specialize in this diet and supported by a dedicated team of nurses and social workers. We can provide detailed counseling and a selection of recipes individualized for your child.
  • Nerve stimulation (VNS): This involves implanting a small pacemaker-like device in the brain 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, making us one of the most experienced pediatric VNS centers in the U.S.

Surgical evaluations

When seizures don’t respond to medication or other treatments, our specialists may recommend an evaluation to see if surgery is an option.

Surgical evaluations are done in the hospital over five to seven days. During this time, we study the child’s seizures and learn exactly what area of the brain they are coming from. If surgery is an option for your child, we will discuss what type of surgery we recommend.

Each week, the Epilepsy Surgery Conference meets to carefully review any surgery we are planning. During the meeting, a wide range of specialists that includes neurologists, neurosurgeons, neuropsychologists, neuropharmacologists, nurses, and social workers discuss all aspects of each child’s case. We will only recommend surgery if we believe it is the very best treatment option for the child.