Pediatrics – Neurology
Epilepsy - Frequently Asked Questions
- What are seizures?
- What is epilepsy?
- What tests might my child’s doctor order?
- What is the treatment for epilepsy?
1. What are seizures?
Seizures are caused by abnormal electrical disturbances within the brain. There are numerous ways seizures may manifest; they may present as staring, quick limb jerks, limb shaking, body stiffening, falls, or sensory disturbances. The seizures may be accompanied by urinary incontinence or breathing problems. Seizures are involuntary and unpredictable. Most seizures are brief, lasting less than 2-3 minutes; however, they can be frightening to witness.
2. What is epilepsy?
Epilepsy is commonly used interchangeably with seizure disorder. Epilepsy simply means that a person has had 2 or more seizures that were unprovoked. For a long while, people did not use the term epilepsy. There were many myths about epilepsy and people feared stigmatization. We now understand that epilepsy is a medical illness with many causes.
3. What tests might my child’s doctor order?
Electroencephalography (EEG) allows physicians to look at the brain’s electrical activity. It can help the physician decide if events are seizures, and if so, what treatments would be indicated. EEGs may be performed for 1-2 hours as an outpatient to gather clues that might indicate a child is prone to seizures. Full day or overnight studies, called long term monitoring (LTM), are performed to record events with EEG and video and identify seizures. We have a highly specialized team of EEG technicians who work hard to make the experience positive.
Once it has been determined a person has epilepsy, the physician attempts to find a cause for the seizures. Depending on the clinical history, a series of other laboratory tests and brain imaging studies may be indicated.
4. What is the treatment for epilepsy?
The majority of persons with seizures/epilepsy respond to medication. However, up to 1/3 of people have seizures that are inadequately controlled. Our epilepsy specialists have expertise with the many seizure medications, the Vagal Nerve Stimulator, and dietary therapies. There are many ongoing research projects including drug trials for seizures. For some, surgery may be indicated; the epilepsy team can help to determine if surgery is a reasonable option.
The ketogenic diet can be very efficacious for epilepsy. It is a specialized, medical diet high in fat with restricted carbohydrates and protein. The protein is titrated for growth. Physicians and nutritionists work closely with families throughout the induction and maintenance phases. Our nutritionists offer informational and support sessions about the ketogenic diet in Boston Medical Center’s demonstration kitchen.