Treatments

Medications

Anti-seizure medications are the first-line treatment for epilepsy, and may be prescribed to relieve your child's seizures or reduce their frequency. If three to five medications have been prescribed and do not work to control your child's seizures, our pediatric experts may recommend evaluation for surgery, consideration of dietary therapy, or placement of a neurostimulator device as the next step.

Dietary Therapy

A dietitian works closely with you and may recommend a low glycemic index diet, modified Atkins diet or Ketogenic diet - eating plans that have been effective in controlling seizures in some patients. These plans restrict carbohydrates and focus on high-fat, high-protein foods that may help the body generate and build up ketones, which can prevent seizures through several different mechanisms, making it an effective treatment for more than 60% of patients with hard to control epilepsy syndromes. URMC is a Charlie Foundation registered Dietary therapy center.

Surgery

Epilepsy surgery is considered when children have medically refractory epilepsy, meaning they have tried two adequately trialed antiseizure medications and failed to achieve seizure control. When children are considered to have medically refractory epilepsy, surgical evaluation can be pursued. This often involves a presurgical evaluation with imaging, and may include surgery to implant electrodes to help identify the area where seizures may be coming from to help guide treatment.

Surgical treatment can include:

• Resection
  • This involves removing the lesion, tumor, malformation, abnormality, or part of the brain that is generating seizures.
• Disconnection
  • This involves disconnecting the abnormal part of the brain, that generates seizures, from spreading to the normal part of the brain.
  • This may include corpus callosotomies, posterior quadrant disconnections, and  hemispherotomies. There are often done minimally invasively with the use of small endoscopes to make surgery safer.

Neurostimulation

• This involves implanting devices that stimulate areas of the nervous system to reduce seizure burden, severity, and frequency.
• This may include VNS, RNS, and DBS:
  • Vagus Nerve Stimulation
    A small pulse generator is implanted in the chest wall or axilla with an electrode that connects to your child's left vagus nerve in their neck. The device delivers electrical pulses that prevent and reduce seizures. Our epilepsy specialists also offer investigational VNS trials to test new ways to program the VNS to detect seizures before they happen.
  • Responsive Neurostimulation
    A small device is implanted into the skull and connects to electrodes placed directly on or in the brain. The RNS monitors your child's ongoing brain waves and gives small electrical impulses to interrupt the electrical patterns that may lead to seizures. This allows for seizure reduction while tailoring treatment to your child's areas of seizure focus.
  • Deep Brain Stimulation
    A small device is implanted into the chest wall and connects to electrodes placed directly in the brain. The DBS stimulates your child’s brain to disrupt abnormal electrical networks and activity that may lead to seizures. This allows for seizure reduction.
• Laser Ablation
  • This involves implanting a small laser fiber into the brain to ablate the area of seizure-focus.
  • This is a safe, minimally invasive treatment for small, deep lesions in the brain that cause seizures.