How We Diagnose and Treat Epilepsy

For those with newly diagnosed seizures or movements or “spells” concerning seizures, CHKD has state-of-the-art video EEG equipment to enable the neurologists and epileptologists – or neurologists who specialize in epilepsy – to confirm the presence of seizures or to reassure families that their child is not having seizures.

Routine EEGs can take from one to two hours in the EEG lab.

In certain situations, your doctor may order a more prolonged EEG (several hours to all day in the EEG lab), an ambulatory EEG (the child wears a recording device at home), or an inpatient video EEG that runs continuously for several days in the hospital (a parent or guardian stays with the patient during their stay to “identify” the events).

In addition to EEGs, the neurologists may order blood work (sometimes including advanced genetic studies) or brain imaging studies, such as an MRI, to aid in the diagnosis.

Typically, patients begin with specific medication selected based on the person’s seizure type, other medical/personal issues, and side effects.

In addition to the standard medications used, the neurologists in the Epilepsy Program often participate in research studies involving new medications. This offers patients who have not responded to standard medication the option of newer, potentially more effective medications.

Non-medication Treatments

The Epilepsy Program at CHKD also has non-medication treatment options available for those individuals for whom medications don’t work or are not tolerated. This includes VNS (Vagal Nerve Stimulator) and dietary therapies.  

The Epilepsy Program has recently expanded its dietary/nutrition services. CHKD has recently hired a Ketogenic Diet dietitian and started a dedicated Ketogenic Diet/Modified Adkins Diet clinic. This clinic allows the neurologist and dietitian to focus on the specific needs and issues involved to help families implement the diet successfully.

The neurologists within our program work closely with the neurosurgeons at CHKD in those cases where surgery is indicated or an option.

Ketogenic Diet

Ketogenic diet has been used for the past century as a non-medication alternative to treating refractory epilepsy, specific genetic disorders and more. A ketogenic diet is a high fat, very low carbohydrate diet which advises the body to no longer use carbohydrates as its main fuel source, but instead uses fat to fuel the brain. Research has shown that use of ketogenic diet may reduce seizure activity. There are multiple forms of this diet such as classic ketogenic diet, modified Atkins diet (MAD), MCT oil diet, and low glycemic index diet. Your doctor and dietitian can help you decide which diet is best suited for your child. This diet can be used in infants, children, and young adults, and is usually considered as a treatment option after failure to achieve seizure reduction after trialing two or more anti-epileptic drugs (AEDs).

Here at CHKD, we have a full ketogenic diet team consisting of a neurologist, registered dietitian, nurse, social worker, and pharmacist. Our team can help you understand your options for ketogenic diet and if it would be right for your child. Please speak with your doctor to get a consultation with our team to discuss the benefits, side effects, etc. of ketogenic diet treatment. Learn more about our ketogenic diet program here.

We Are Here To Help In All Ways

In addition to the Ketogenic Diet and dietitian, our program also utilizes other services to aid in the diagnosis and treatment of epilepsy.  These include a neuroradiologist, a pediatric neuropsychologist, a pharmacist specializing in the various anti-seizure medications, and a social worker.