What We Treat

Treating Epileptic Seizures in Children

The Epilepsy Division at Cohen Children's Medical Center provides comprehensive treatment for children diagnosed with pediatric epilepsy.

Epileptic seizures in children can happen for a wide variety of reasons, and seizures in a newborn will be different from those in a toddler, child or adolescent. Only three percent of all children will have a seizure and half of those are febrile seizures, which can occur with a high fever. Epileptic seizures in children can occur in one out of every 100 children.

No two seizures are the same, but they do fall into specific categories. Neonatal seizures happen within 28 days of birth and can be difficult to detect since babies may not convulse, but instead smack their lips, stop breathing for short periods, or their eyes may look in different directions. Partial seizures involve only part of the brain and only part of the body.

Generalized seizures are broken down into subcategories:
 

• Convulsive seizures are marked by the uncontrollable convulsions that are experienced during the seizure, and your child is most likely drowsy or tired afterwards and may have lost control over their urine or bowels. Most of the time, your child will not remember the seizure, and may have suffered an injury that can be as minor as a bitten tongue or as painful as a broken bone.

• Tonic seizures are a continuous rigidity of the muscles, while tonic-clonic seizures are the repeated jerking of the body. Infantile spasms generally occur in children younger than 18 months, are usually associated with mental retardation, and are the sudden contraction of muscle groups which appear as a flexed stature. These seizures are most common upon waking.

• Absence seizures or petite mal seizures occur when the child appears to be staring off into space or their eye blinks with no awareness of what is going on around them. These tend to start and stop suddenly and are difficult to diagnose. Usually these are discovered when the teacher observes the child daydreaming, losing their place while reading, or missing assignments or parts of directions.

• Status epilepticus are prolonged seizures lasting longer than 5 minutes. This type of epileptic seizure usually happens in children under two and is most likely a tonic-clonic type with repeated bodily jerking. Any seizure lasting a long period of time can be dangerous. Anytime a seizure lasts longer than 1-2 minutes or if it's your child’s first seizure, call 911 and ask for assistance.

If your child has epilepsy or some other seizure disorder, he or she may be treated with medications. Some medications may be prescribed to prevent seizures, which is the most common drug therapy. Others drug therapies disrupt a seizure once it has started. Be sure to follow all directions closely and report any unusual side effects to your child’s doctor. Some medications work better for some children than others. Finding the right drug therapy and the proper dose may take time. Please have patience while this process is being worked through. Unfortunately, there is no test that will definitively recommend a drug or dosage.

Surgery is not an option in all cases. It may be considered when nothing else is working to control your child’s seizure disorder and there is a defined focus for the seizure or other special circumstances. Traditional therapies are usually tried first. Before putting your child through surgery, be sure to understand the risks, possible complications and all of the details first.

At Cohen's Children's Medical Center we also offer multidisciplinary outpatient services and specialized treatments, including:

• Anti-epileptic drug therapy
• Ketogenic diet
• Investigational anti-epileptic drugs
• Multidisciplinary evaluation for the surgical treatment of epilepsy in conjunction with neurosurgery

What to Expect:

• A thorough history and physical is completed at the initial visit
• Based upon the outcome of that evaluation, metabolic and genetic testing may be requested, as well as brain imaging and an EEG

 
Long-term inpatient video-EEG monitoring:

• Children are admitted to the Cohen Children's Medical Center for continuous video-EEG monitoring. Computer algorithms allow for the detection and analysis of seizures which are missed by observers.

This procedure is useful in:

• Distinguishing seizures from non-epileptic events such as abnormal movements and tics
• Allowing for accurate classification of seizures that permit specific treatment
• Determining the site of origin of seizures in patients who may be candidates for surgical treatment

 
Long-term ambulatory homebound EEG:

• 24 hour, homebound EEG monitoring is available to rule out seizures, or to further define and quantify the seizures.