From the November 2018 issue

Epilepsy Awareness: Signs and Treatment

In honor of Epilepsy Awareness Month in November, a board-certified pediatric epileptologist and clinical neurophysiologist at the Children's Hospital of Michigan offers insight and advice for parents.

Your brain is constantly sending out signals to the rest of your body through your nerves. But, like all communication, sometimes the wires get crossed – and there’s some miscommunication between the brain and the nerves of your body.

The outcome of this particular miscommunication, however, can be frightening when it displays itself as an epileptic seizure.

Epilepsy, which is a disease of the brain caused by a misfire between the brain and the nerve cells, affects roughly 2 million adults and impacts approximately half a million of children.

“It is more common in young children less than 2 years of age,” says Dr. Aimee Luat, M.D., a board-certified pediatric epileptologist and clinical neurophysiologist at the Children’s Hospital of Michigan. While the majority of children tend to outgrow epilepsy, the disease can be terrifying for families.

Here, in honor of Epilepsy Awareness Month in November, Dr. Luat offers signs to look for and treatment options to consider if you suspect your child has epilepsy – or if he or she was recently diagnosed.

Signs of epilepsy

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There are two categories of seizures: generalized and focal. When someone experiences a generalized seizure, the nerve cells on both sides of the brain are misfiring, which can result in muscle spasms, blackouts or falls. Focal seizures, on the other hand, start in a specific part of the brain and can cause both physical and emotional effects depending upon what part of the brain is involved.

There are various signs and symptoms to look for, Dr. Luat says. “For example, they may present with a staring episode or appear to be daydreaming.”

Additional signs include:

  • Eye fluttering or blinking
  • Breathing problems
  • Jerking episodes
  • Sudden loss of awareness
  • Sudden falling

“These are the things that a parent should look for in a child that is probably having a seizure,” Luat says.

Epilepsy treatment

“If a patient is diagnosed with epilepsy, the No. 1 treatment approach is the use of anti-seizure medication,” she says.

The medication prescribed depends on the type of seizure a child is experiencing, she adds.
The majority of children respond well to medication, but approximately 20-30 percent can develop medically uncontrolled seizures that continue despite the use of 2 or more appropriate anti-seizure medications.

These children can be evaluated at the Children’s Hospital of Michigan’s Pediatric Epilepsy and Pediatric Epilepsy Surgery Program, which has been designated as a Level-4 Epilepsy Center for years.

“As a Level-4 Epilepsy Center, we offer comprehensive treatment plans with state-of-the-art technology to figure out if there is a seizure focus,” she says. “Dr. Eishi Asano, the medical director of our neurodiagnostic lab, has developed a four-dimensional brain mapping technique to localize motor, sensory, language, and memory function for aiding in maximizing the quality of life after epilepsy surgery. We also offer stereo-EEG, a minimally invasive procedure to identify seizure focus in the brain.”

Pediatric epileptologists and neurosurgeons, along with neuropsychologists, neuroradiologists and other medical experts dealing with epilepsy, are on staff and able to diagnose each child.

For children who do not respond to the anti-seizure medications, adoption of a ketogenic diet, a diet which is high in fat and low in carbs, could help to control epilepsy.

Surgical treatment options including focal cortical resection, hemispherotomy, corpus callosotomy, vagus nerve stimulator (VNS) implant, and multiple subpial transection are also options for children who have not been successfully treated through medications. “Dr. Sandeep Sood, our neurosurgeon, has pioneered the application of a three-dimensional endoscope for minimally invasive epilepsy surgery.”

For more information on the Children’s Hospital of Michigan, visit the Children’s Hospital of Michigan website.

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