The majority of persons with seizures/epilepsy respond to medication. However, up to 1/3 of people have seizures that are inadequately controlled. Epilepsy specialists at BMC 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.
Dietary therapy can be very efficacious for epilepsy. There are several different diets used by the Epilepsy Nutrition Program at Boston Medical Center (Ketogenic, MCT oil diet, Modified Atkins, and low glycemic diet). The epilepsy nutrition team looks the whole child and family unit when deciding the best dietary option. Each of the diets are high in fat with restricted carbohydrates and protein. Physicians and nutritionists work closely with families throughout the induction and maintenance phases to offer information, support, and in person food preparation lessons in The Teaching Kitchen.
For more information about the low-glycemic diet see our food blog.
Surgery to reduce or control seizures is a well-established option for children and adults with epilepsy when medical therapies have failed. In addition to stopping or reducing the frequency of seizures, surgical goals are to reduce the amount of medications and improve the child’s development and quality of life. Recent studies show that earlier surgical evaluation and intervention may increase the chances for a better overall outcome.
Surgery may be considered when:
- Medications have failed to control seizures
- The seizures start from one part of the brain
- There is a localized lesion in the brain
- The surgery will not cause damage to important skills like speech, memory or motor function
Surgical evaluation is an extensive process that requires a multidisciplinary team including specialists in neurology, neurosurgery, neurophysiology, neuropathology and neuropsychology. A first step is inpatient EEG-Video monitoring to identify where seizures originate in the brain. Additional testing, such as a brain MRI, helps evaluate brain anatomy.
The decision to proceed with a further surgical evaluation and/or intervention is made after each phase of the work-up and comprehensive review of the findings by the epilepsy team.
The choice of surgical procedure depends on the nature of the seizure syndrome. The resection can be small and limited or more extensive.