If medicines do not control a child's seizures, he or she may be a candidate for surgery.
The most common form of epilepsy surgery removes a fairly small area of the brain where seizures begin. Sometimes, larger areas are removed.
Other surgery, performed less often, blocks nerve pathways in the brain to stop the spread of seizures from one part of the brain to another.
If medications fail to control a child’s seizures, your doctor may recommend a special high fat, low carbohydrate, restricted calorie diet. It is called a ketogenic diet.
Calories are strictly limited, and parents have to be very careful not to allow the child to eat anything -- even cookie crumbs or toothpaste -- that isn't on the diet or hasn't been pre-measured and pre-weighed within the formula.
The diet requires a team effort -- the family, the physician, the dietitian, the nurse education team, and, if the child is old enough, the child himself -- all working together to make sure the diet is followed and any side effects are monitored.
WARNING: The ketogenic diet is serious medicine. It is not a do-it-yourself diet. It could have serious effects if not monitored by a physician and dietitian.
Vagus Nerve Stimulation (VNS)
Vagus nerve stimulation is a new type of treatment that may be tried when seizures cannot be controlled by other methods.
The treatment works by sending regular small bursts of electrical energy to the vagus nerve, a large nerve in the neck that leads directly into the brain.
The energy comes from a small, disk-like generator, about the size of a stop watch, that is surgically implanted under the skin on the chest wall.
The generator is connected to lead wires under the skin, the ends of which are wound around the vagus nerve. The operation which places the device can be done on an inpatient or outpatient basis.
Specialized care for children with hard-to-treat epilepsy is available at special centers around the country. They offer in-depth evaluation, surgery, the ketogenic diet, and VNS therapy.
For information about sources of specialized care near you, contact the Epilepsy Foundation in your community or the national office at (800) 332-1000.