Pediatric Epilepsy Treatment Services in Augusta, GA

Treatment Services

No single treatment is perfectly suited to all patients with epilepsy. Therefore, we make available all of the methods useful in the treatment of seizures, including: therapy with all  medications presently available in the United States, new experimental drugs, the ketogenic diet, vagal nerve stimulation and epilepsy surgery.
 

 

 

Drug Therapy

Many new medications for the treatment of epilepsy have been developed over the last few years. These medications must be utilized in a methodical, careful manner, often requiring months to determine the best single drug or combination of drugs. The goal of this treatment is to control seizures completely while keeping side effects to a minimum. We have experience using all the approved medications for epilepsy.

We are also involved in ongoing trials utilizing newly developed epilepsy drugs. Particular patients may meet the criteria for these new medications.

Ketogenic Diet

This dietary form of therapy has been known for most of this century, and its effectiveness has long been recognized. In the past ten to fifteen years, certain aspects of the diet have been improved and the importance of rigid adherence to the diet has become better understood. The diet can be extremely effective in children who have not responded to drugs and who are not candidates for epilepsy surgery.

Vagal Nerve Stimulation

This method of treatment may also be useful for the treatment of patients who have poorly controlled seizures which have not responded to medication. Although we do not understand why stimulation of the vagus nerve helps epilepsy, this procedure has proven effective in a number of children.

During a minor surgical procedure, an electrode is surgically implanted around the vagus nerve in the neck. A small box controlling the electrode is implanted under the skin of the chest and connected to the electrode. The electrode transmits an electrical current that stimulates the nerve. The optimum treatment for the seizures is accomplished by adjusting the electrical characteristics of the stimulation. The period of adjustment may require eight to ten months to achieve the best results for the seizures.

Surgical Treatment for Epilepsy

When seizures do not adequately respond to the above measures, we help families consider the option of surgical therapy. In general, a child who is a candidate for surgical treatment of seizures usually has seizures arising from one part of the brain. In order to determine if the child is a candidate for epilepsy surgery, he or she first undergoes a "Phase I" evaluation in our Epilepsy Monitoring Unit (EMU). The EMU is a combined adult and pediatric epilepsy six-bed unit where the child is connected to continuous EEG monitoring with video camera recording. The purpose of this procedure is to capture a seizure in progress and to determine the specific portion of the brain which is causing the seizure. A test called an ictal SPECT scan may also be performed along with an MRI to determine the exact area of the brain involved.

Impact of Epilepsy on Learning Abilities

One of our neuropsychologists, Dr. Morris Cohen or Dr. Greg Lee, may then administer tests to determine the impact of the epilepsy on learning abilities, according the specific area of the brain found to be affected. If the "Phase I" evaluation is positive, but the results are not sufficient in order to plan surgery, a "Phase II" evaluation is performed. In this case, a grid can be surgically implanted for electrical monitoring over the surface of the brain. This is done to assess even more carefully the area of the brain involved. After all the information is collected, the patient's case is discussed at a joint conference among the epilepsy physicians, neurosurgeons, and neuropsychologists. In this conference, the best possible surgical approach is developed.

If you would like general information regarding the Georgia Regents Medical Center Pediatric Epilepsy Program, please call 706-721-3371 or [email protected].

If you would like to make an appointment, please call 706-721-4581, option 1.