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Epilepsy and Seizures
Gillette Children’s Specialty Healthcare is the Twin Cities’ only nationally ranked Best Children’s Hospital in pediatric neurology and neurosurgery. Our Center for Pediatric Neurosciences offers expert diagnoses and treatments for seizures and epilepsy in children and teens. Our goal is to work closely with families to provide the most effective management and best care for children who have epilepsy.
Many of our patients who have epilepsy also have complex associated conditions, such as cerebral palsy, developmental delays or traumatic brain injuries. That’s why we offer a large team of specialists and extensive support services. Our focus is on caring for the whole child.
Why Choose Gillette?
- Our experienced neurologists collaborate with families to find the best care path for each child.
- Our neurodiagnostics services include electroencephalograms (EEGs) and video electroencephalograms (VEEGs) to assist in diagnosing and managing seizures and epilepsy.
- We offer neuroimaging tests—including magnetic resonance imaging (MRI) and computed tomography (CT)—to provide information crucial to making a diagnosis.
- Our neuropsychologists and psychologists help to evaluate brain function and its effects on behavior and abilities.
- We ensure excellent communication with patients by having a team of physicians and nurses who work closely together.
- Our Pediatric Intensive Care Unit (PICU) provides the highest level of around-the-clock care for patients who are critically ill.
- Our goal is to maximize our patients’ physical, mental and emotional health.
Definition of Epilepsy and Seizures
Our brains have constant electrical activity in and between cells. A seizure is an abnormal electrical discharge in brain cells that causes a change in normal activity, behavior or movement.
Epilepsy is diagnosed when a person has two or more unprovoked seizures. A person who has only provoked seizures (febrile seizures, seizures after head trauma) will not receive an epilepsy diagnosis.
Causes of Epilepsy and Seizures
Epilepsy can have many causes. The neurologist will order tests to help determine why a child has epilepsy. Some of the known causes for epilepsy include:
- Brain injury caused by low levels of oxygen in the blood
- Brain injury caused by premature birth
- Chromosomal abnormalities
- Congenital brain malformations
- Genetically mediated epilepsy syndromes
- Other genetic factors
- Infections, including blood infections or central nervous system infections, such as bacterial meningitis, viral encephalitis or tuberculosis
- Metabolic disorders
- Traumatic brain injuries
- Tumors of the nervous system
What Seizures Look Like
Seizures range from mild to severe. Indications that a person is having a seizure include:
- Sudden changes in alertness or behavior
- Uncontrolled staring or “zoning out” behaviors
- Repetitive, involuntary jerking movements
- Loss of consciousness
- Changes in breathing patterns
Diagnosis and Tests for Epilepsy
We use many methods to evaluate patients who have seizures. Our goal is to determine the types of seizures occurring and to uncover their underlying cause. This allows us to develop the most effective treatment plan.
Five-Axis Approach to Diagnosis
When evaluating patients for seizures and epilepsy, we use a classification system developed by the International League Against Epilepsy (ILAE). The system outlines a logical evaluation process and provides terms that we use to describe our findings.
Our methods of classifying our findings are consistent with those used by many other providers worldwide. The ILEA calls each classification category an axis.
- Axis 1 (Seizure Event): We describe a patient’s seizures in detail, using findings from tests and observations from the patient and family.
- Axis 2 (Seizure Type): Based on the description, we try to identify the particular type of seizure a patient experienced.
- Axis 3 (Epilepsy Syndrome): We try to determine if patients have a defined epilepsy syndrome—a particular combination of signs and symptoms that can include seizure type, the age when seizures started, various clinical findings, and other factors.
- Axis 4 (Seizure Causes): We try to identify underlying causes of the seizures, such as brain injury, genetic disorders, brain malformations, and conditions associated with premature birth.
- Axis 5 (Impairments): We identify impairments or quality-of-life disruptions caused by the seizures. Our findings are guided by a framework, developed by the World Health Organization, called the International Classification of Functioning, Disability and Health.
To support our five-axis approach to diagnosis, we conduct a number of evaluations:
- History: Our clinicians obtain a history of the seizure event and the child’s medical and neurologic story. Observations from families and primary care providers help us identify the seizure type and possible causes.
- Neurological Examinations: A pediatric neurologist thoroughly examines patients who’ve experienced seizures.
- Neuropsychology Evaluations: A neuropsychologist might evaluate patients with epilepsy to determine whether the seizures or associated conditions are affecting learning and behavior. An early neuropsychology evaluation allows for tracking skills and abilities as they change over time.
- Psychology Evaluation: Psychologists can help in determining a patient’s intellectual development and assist in planning for school accommodations, if needed.
Tests and Tools
Our specialists might order a number of tests to support diagnosis, including:
- Electroencephalogram (EEG) and video EEG (VEEG): An EEG measures electrical activity in the brain through small electrodes placed on the head. An EEG can help determine the seizure type. With VEEG, we add a video camera to record images during the test; the images help determine how body movements correspond with brain activity.
- Magnetic Resonance Imaging (MRI): When an EEG indicates that abnormal electrical activity in a particular area of the brain is triggering seizures, we might recommend an MRI—a test that uses magnetic fields to obtain detailed images of the brain.
- Sleep Study (Polysomnography): During an overnight sleep study, we can monitor and record electrical activity in the brain during sleep. We also can observe air flow, respiratory effort, oxygen saturation and muscle movement.
- Lab Tests: We might order blood tests to measure levels of electrolytes, glucose, calcium and magnesium. We also might check the samples for the presence of toxic substances.
- Genetic Testing: We might order genetic tests to determine if genetic factors increase a patient’s likelihood of having seizures.
Gillette offers a variety of treatment options for epilepsy, with interventions selected to best suit each child.
Medical treatments can include antiepileptic medications. At Gillette, our comprehensive diagnostic evaluations help us identify which medications are best suited to treat a patient’s seizures. In some cases, exploring various medications and doses helps our patients achieve the best possible results.
For some patients with severe epilepsy, a strictly controlled diet can decrease or eliminate seizures. Gillette specializes in providing the following highly controlled dietary treatments for epilepsy:
Vagus Nerve Stimulator
Some patients who have epilepsy benefit from implantation of a vagus nerve stimulator (VNS) to control seizures. Our neurosurgeons specialize in that procedure, having implanted more than 100 VNS devices. We also offer consultations, support and referrals for patients who might benefit from other neurosurgical procedures.
Our Epilepsy Services
Patients who experience seizures or have epilepsy need complete diagnostic services and a team of experts to provide comprehensive care.
At Gillette, a patient’s core seizure and epilepsy team typically includes experts in:
- Neurology (pediatric neurologists, epileptologists, and neurology nurse practitioners)
- Nursing (both inpatient and outpatient)
Patients who experience seizures or have epilepsy often also receive care from providers in the following specialties and services:
- Child life
- Medical genetics and genetic counseling
- Neurodevelopmental pediatrics
- Neurodiagnostics, for tests such as electroencephalograms (EEGs), video electroencephalographs (VEEGs) and overnight sleep studies (polysomnography)
- Nutrition and feeding
- Pediatrics and general medicine
- Radiology and imaging
- Rehabilitation medicine
- Rehabilitation therapies, including occupational, physical, and speech and language therapy
- Sleep medicine
- Social work
- Therapeutic recreation
Working together, we treat the whole child—not just the seizures.
For more information about Gillette’s services, search Conditions and Care.
Publications and Resources Related to Epilepsy
Epilepsy Advocacy and Support Organizations
The sites below offer educational information, resources, and advocacy events and news for people who have epilepsy, their families and their communities.
- Epilepsy Foundation
- La Epilepsia
- Epilepsy Therapy Project Initiative of the Epilepsy Foundation (Epilepsy.com)
- Epilepsy Foundation of Minnesota
- Healing Well Epilepsy Resource Center
- American Epilepsy Society
- Dravet Syndrome Support
- International League Against Epilepsy
- CURE (Citizens United for Research in Epilepsy)
- Lennox-Gastaut Syndrome Foundation (LGS Foundation)
- ICE Epilepsy Alliance for Intractable Childhood Epilepsy
- International Rett Syndrome Foundation
Camps and Activities for Children Who Have Epilepsy
Ketogenic Diet Support Organizations
Interactive and Educational Resources
Resources for Health Care Providers
Books in Our Health Resources and Education Center
At our St. Paul Campus, our Health Resources and Education area maintains a library of books, videos and other materials about epilepsy and other health care topics.
From our collection, we recommend the following books for school-age children:
- Growing Up With Epilepsy, by Lynn Bennett Blackburn
- Becky the Brave: A Story About Epilepsy, by Laurie Lears
- Taking Seizure Disorders to School: A Story About Epilepsy, by Kim Gosselin
- My Friend Emily, by Susanne M. Swanson
From our collection, we recommend the following resources for teens:
- Teenagers With Epilepsy, by Paul Levisohn
- Epilepsy in the Teen Years (Video from Epilepsy Foundation of America)
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