After my son started experiencing seizures, his pediatrician suggested that he might have epilepsy and has referred us to a specialist. What kinds of tests will be performed and what treatments are available?
It surprises many to hear that epilepsy affects more people than cystic fibrosis, multiple sclerosis, muscular dystrophy, and tuberculosis combined. More than three million Americans have epilepsy, which is the most common type of seizure disorder. Each year, 200,000 new cases are diagnosed and 45,000 of those diagnoses are in children under the age of 15. While epilepsy can begin at any age and strike at any time, it often starts in childhood.
Epilepsy is triggered by a recurrent electrical discharge in the brain that disturbs the normal functioning of the body’s nervous system, and can result in temporary loss of consciousness or temporary changes in behavior. An epileptic seizure can cause convulsive movements, loss of urinary continence, confusion, and lethargy.
If your physician suspects that your child has epilepsy, an accurate diagnosis of the condition is crucial before treatment can begin. In addition to a detailed documentation of your child’s medical history, a series of painless neurological tests will be administered to definitively diagnose the condition.
An electroencephalogram, which records brain waves through electrodes placed on the scalp, is often the first diagnostic tool. In conjunction with video monitoring, the electroencephalogram detects abnormalities in the brain’s “wiring,” or electrical activity. The video, which is available at major epilepsy centers like the one at New York Methodist Hospital, permits the study of brainwave activity at the same time that a seizure or “spell” is occurring. The test helps doctors to determine the nature of these seizures, as well as how to most effectively treat the condition.
Also used in the diagnosis of epilepsy are scans of the brain, which may include computed tomography, magnetic resonance imaging, functional magnetic resonance imaging, positron emission tomography, and single photon emission computed tomography.
A treatment plan will be based on your child’s specific needs. Doctors generally start by treating epilepsy with medication. If that doesn’t work, surgery or another type of treatment may be recommended. Surgery is most commonly performed when tests show that the seizures originate in a small, well-defined area of the brain that doesn’t interfere with vital functions like speech, language, or hearing.
Vagus nerve stimulation, which involves implanting a device in the chest to deliver short jolts of electrical energy to the brain, has been shown to decrease the frequency of seizures as well.
The emotional toll of seizures on children can be traumatic, and leave them with considerable anxiety about when their next seizure will occur. So finding the best treatment for children with epilepsy is also important to their psychological health. With the right approach, the vast majority of people with epilepsy are able to control their seizures, and should your son receive an epilepsy diagnosis, it’s important for him to understand that it’s very likely that he will still be able to lead a perfectly “normal” and happy life.
