Our pediatric epilepsy specialists, called epileptologists, provide care for infants, toddlers, children, adolescents, teenagers, and young adults, including:

 

Expert Evaluation

• Testing and monitoring will allow for an individualized treatment plan.

Testing and Monitoring

• Electroencephalogram (EEG) testing and monitoring
• Inpatient epilepsy monitoring unit
• Intracranial EEG monitoring
• Intracranial brain mapping
• 3T magnetic resonance imaging (MRI)
• Functional magnetic resonance imaging (fMRI)
• Positron Emission Tomography (PET)
• Neuropsychology Testing

Pediatric Specific Medications and Therapies

• Anti-epileptic medications
• Ketogenic and modified Atkins diets
• Surgical Options
  • Intracranial electrode placement
  • Resective surgery
  • Temporal lobectomy
  • Corpus callosotomy
  • Hemispherectomy
  • Vagus Nerve Stimulation

In many cases, medication management will be needed for the long-term management of childhood epilepsy. Because we are focused only on children's care, we take a personalized care approach for seizure medication dosage for each child's unique needs. Our team includes specially trained pediatric pharmacists to ensure that all medications prescribed to children are safe, effective, and adequately dosed for each patient based on their appropriate age.

Nutritional support can be a critical component of epilepsy management. By basically limiting carbohydrates, research has shown that either a ketogenic diet that is high fat and used for babies through formula or when tube feeding is required or a modified Atkins diet that restricts carbohydrates successfully helps limit seizure activity. This research has shown that both diets are equally useful, and we work with patients and families to determine which is easier to manage day to day for individual patient needs.

The ketogenic diet is essentially a diet high in fat, and low in carbohydrates yet provides enough protein for growth. While most children with seizures are treated with medicine, the medicine doesn't stop the seizures or produces an unwanted side effect. The ketogenic diet can be used to treat seizures. Research has indicated that large levels of ketones can help reduce some childhood seizures such as myoclonic, absence, and generalized tonic-clonic or grand mal seizures as the type of seizures associated with Lennox-Gastaut Syndrome.

Our specially trained clinical nutritionist and neurologist coordinate any dietary needs to help patients and families understand how to implement the carbohydrate restricted diets into your child's daily living.

At Arkansas Children's, our skilled board-certified and fellowship-trained pediatric neurosurgeons are specifically trained for the surgical treatment of epilepsy in children. In many cases, surgical intervention can stop seizures completely. Our team carefully evaluates the cause of seizures and the frequency, severity and duration of seizures. With the identification of the area of the brain where the seizures start, the surgical removal of the seizure focus, called a temporal lobe resection, can be considered to remove the area that controls seizures.

Another surgical option, Vagus Nerve Stimulation, is a result of the Vagus Nerve Stimulator's surgical placement, approved by the U.S. Food and Drug Administration in 1997. As another treatment option for seizures, the epilepsy specialists at Arkansas Children's have surgically placed these small devices regularly since their approval. The stimulator is a device that is placed under the left side of the chest. It has soft, flexible wires, or leads, that travel under the skin and up the neck, wrapping around the vagus nerve in the neck. This nerve carries information to the brain, and the device emits a mild, brief current or stimulation to the vagus nerve within a regular interval. The stimulator's recipient can carry a special magnet to trigger extra stimulation to stop or lessen a seizure.

At Arkansas Children's, our goal is an exceptional patient experience and enhanced patient care. We know caring for a child with any medical issue impacts the whole family so we provide expert care that is convenient for families. Our specially trained epileptologists, neurologists and neurosurgeons come to Arkansas Children's regional locations so children can see our specialists closer to home. Also, we provide electroencephalogram (EEG) testing right in our clinics – often the same day as your appointment – so our team can closely monitor any seizure activity by detecting any abnormalities of the brain's activity.

Our goal is your goal – for your child's best quality of life through enhanced epilepsy care. We are here to help you understand what to tell your doctor. Because seizures don't often happen in the doctor's office, it is important to document the sequence of any seizure – before, during and after – how long it lasted and how long it took for your child to recover. Because our specialists are epilepsy experts, our team can answer your questions and we can talk through any concerns for epilepsy management.

What is Diastat?

Diastat is a rectal medication of diazepam (valium) approved for treatment of prolonged seizures or clusters of seizures.

When should Diastat be given?

Diastat should be given for seizures lasting longer than five minutes or a cluster of seizures that occurs one right after the other.

How soon should the seizure stop after giving Diastat?

After giving the Diastat, the caregiver should notice effects of the medication within five minutes.  If the seizure continues another five minutes, a second Diastat can be given as well as seeking medical attention (call 911 or going to local emergency room).

If Diastat stops the seizure, what should you do?

Continue to monitor the child.  It is not always necessary to take him/her to the emergency room unless he/she is having trouble breathing or has become injured during the seizure.

What are the side effects of Diastat?

The most common side effect is sleepiness.  The child will most likely be tired from the seizure activity, also.  Other less likely side effects include:  dizziness, headache, abdominal pain, nervousness, feeling unsteady or clumsy, or a rash.

Helpful Hints

• Always lubricate your Diastat syringe with KY jelly before administering to your child.
• Place the tip of the syringe in the rectum just far enough so that all of the medicine goes into the rectum. 
• Hold the butt cheeks together after administering to assure all the medicine has been absorbed.
• Be sure that your child has Diastat with him/her wherever he/she goes.

Most seizures end after 1 to 2 minutes without harm.  These seizures do not usually require a trip to the emergency room.  You do not usually have to do anything if a person has brief periods of staring or shaking.  Seizure first aid should be used with shaking or jerking lasting longer than a few seconds.

If you child begins to have a seizure:

• Lay him/her on the floor on his/her side to keep his/her airway open
• Clear the area around him/her of anything hard or sharp
• Do not try to hold him/her down or stop his/her movements
• Loosen any tight clothing, especially anything around his/her neck
• Do not put anything in his/her mouth – she will not swallow his/her tongue
• Time the seizure

If your child’s seizure lasts longer than 5 minutes:

• Administer Diastat if his/her neurologist has prescribed this medicine
• If Diastat has not been prescribed, call 911 or take your child to your local emergency room

If your child’s seizure continues after administration of the Diastat:

• Administer the 2nd Diastat syringe if the seizure has lasted 5 minutes after the 1st syringe was given
• Prepare to call 911 or take your child to your local emergency room

Web Sites:

• Epilepsy Foundation
• Centers for Disease Control and Prevention
• Epilepsy.com
• United States Department of Education
• About.com - Special Needs Children
• National Institute of Neurological Disorders and Stroke

Documents:

• Caregiver Notification Sheet
• Seizure Calendar

Although your child has been diagnosed with a seizure disorder, we encourage you to let your child live a normal life.  Children with seizures do not usually have any physical limitations or activity restrictions. 

There is a chance that your child could lose consciousness during a seizure, so there are certain circumstances that your child should avoid or be closely monitored.  Your child’s life could be at risk if he/she were to lose consciousness during certain activities.

• Swimming/Taking a Bath:  Your child should always be closely monitored while in the water.  Encourage your child to take showers instead of sitting in a tub of water.
• Fire:  Your child should always be closely monitored around campfires, fireplaces, or hot ovens/stoves.
• Heights:  Your child should always be closely monitored when activity includes heights – monkey bars, trees, etc.
• Driving:  Arkansas law requires your child to be seizure-free for one year before driving.

Please be aware that your child may have increased seizures when he/she is sick, running a fever, sleep-deprived, or under stress.  It is also very important that your child not miss his/her medication because this could cause increased seizures.