Treating Pediatric Epilepsy

While there is no one definitive treatment or cure for pediatric epilepsy, there are medicines and other treatment options that can help keep seizures under control. Finding the right treatment plan can help children and youth with epilepsy (CYE) thrive.

What physicians treat pediatric epilepsy?

If a child is diagnosed with epilepsy, their pediatrician should refer them to a special physician or team of physicians who treat pediatric epilepsy. The pediatrician and specialists or team of physicians should work in coordination to ensure that the CYE receives the care they need. Learn more about physicians who treat epilepsy.

What are the treatment options for pediatric epilepsy?

Many CYE take medicines to prevent seizures. These medicines are called anti-seizure medications (also called anti-epileptic or anti-convulsant drugs). A child or adolescent may need to try more than one medicine to find the one that works for them.

If medications do not work to control seizures, a child’s physician may recommend other treatment options, like:

• A special dietary therapy, like the ketogenic diet, modified Atkins Diet, or low glycemic index treatment.
• Medical devices that stimulate the nervous system to help reduce seizure frequency.
• Brain surgery, if seizures cannot be controlled with other treatment options.

Special diets

If medicine does not work to control seizures, physicians may recommend one of these special eating plans:

• The ketogenic (“keto”) diet — a high-fat diet that involves limiting calories and food with carbohydrates and protein.
• The modified Atkins diet — a less restrictive version of the ketogenic diet. It mostly includes food with fat but, unlike the ketogenic diet, does not limit carbohydrates, protein, or calories as much.
• Low glycemic index treatment — an eating plan that limits carbohydrates and mostly includes food that does not raise blood sugar. Food that has a higher glycemic index raises blood sugar more than food with a lower glycemic index.

These diets should never be undertaken by a person or family without the supervision of a physician and dietician.

Medical devices

Another treatment option is a stimulation device that is placed by a surgeon either under the skin in the chest or in the brain itself. These devices send small electric currents to the brain and signal it to stop producing seizures. If a child needs a medical device to control their seizures, their physician will determine which treatment and device is right for them. Current devices include the vagal nerve stimulator (VNS), responsive neurostimulator (RNS), or deep brain stimulator (DBS).

Brain surgery

Finally, a child’s physician may recommend brain surgery if their seizures cannot be managed with other treatment options. If surgery is recommended, a physician will run tests to decide what kind of procedure will work best. There are 2 main types of brain surgeries for seizures:

• Removing the part of the brain where seizures start
• Disconnecting parts of the brain to prevent seizures from spreading and causing symptoms

How can parents and caregivers support their child’s treatment plan?

Treating pediatric epilepsy is a team effort. Physicians work together with a child’s parents or caregivers to keep seizures under control. To get the most out of their child’s treatment plan, parents and caregivers should:

• Follow directions provided by the physician, especially when it comes to giving seizure medicine.
• Work in partnership with your child’s physician to develop a seizure action plan for seizure emergencies.
• Talk with your child’s physician before making any changes to a child’s diet or stopping seizure medicine.
• Keeping a log of how frequently a child is having seizures.
• Check in with the child’s physician regularly to evaluate how well treatment is working.

Parents and caregivers can also help their child build healthy habits like getting enough sleep, managing stress, and participating in physical activities they enjoy. Practicing these habits can help keep seizures under control. 

Additional Resources

For more details, check out these helpful resources:

• HealthyChildren.org: Epilepsy Diagnosis and Treatment
• The Epilepsy Foundation: Treatment 101
• The Epilepsy Foundation: Ketogenic Diet