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Pediatric Epilepsy Program

Oct 21, 2015

University of Iowa Stead Family Children's Hospital treats all types of pediatric epilepsy using combinations of the newest anti-epileptic medications and the latest surgical treatments.

Our medical team uses a multidisciplinary approach. Initially, all children undergo a complete evaluation by the pediatric neurology team. Determining the type and causes of the seizures is crucial to determining the best treatment strategy.

If the seizures are caused by a mass or lesion in the brain, the mass or lesion can be surgically removed (resected). With this type of epilepsy, the likelihood of a patient being seizure-free after surgery is very high (up to 80 percent). In other cases, a child may have an epileptic syndrome or seizures on one side of the brain. Surgical treatment in this case may include a hemispherotomy, which is an operation that disconnects one half of the brain (hemisphere) from the other half of the brain without removing it. Other surgical treatments that decrease seizures include corpus callosotomy—cutting the corpus callosum, which is the band of tissues that transmits messages from one side of the brain to the other—and vagus nerve stimulation (implanting a device to generate pulses of electricity to stimulate the vagus nerve, which can decrease seizure frequency.

Based on an initial evaluation, if the seizures are not caused by a lesion or mass or localized area, they can be treated with antiepileptic drugs (AEDs). In these cases, AEDs are used as the first line of treatment. Approximately 50 percent of children with epilepsy will become seizure-free with their first medication. Another 15 percent will become seizure-free with a second medication. As many as 15 to 30 percent of children with epilepsy will continue to have seizures even after treatment with medication. This is often referred to as uncontrolled, intractable, or refractory epilepsy.

When medication fails to completely prevent seizures, even if it's just one or two seizures every couple of months, children will undergo further evaluation for surgical treatment. Advancements in neurosurgery and neuro-anesthesia have dramatically decreased the risk of undergoing surgery for the treatment of epilepsy. Multiple studies have shown that surgery can allow for many children with epilepsy to be seizure-free. The earlier children with medically refractory epilepsy are evaluated, the sooner we can take steps to treat them properly.

Conditions we treat

  • Complex partial epilepsy
  • Extra-temporal lobe epilepsy
  • Hemimegalencephaly
  • Lesional epilepsy
  • Medically intractable epilepsy
  • Post-infectious epilepsy
  • Post-stroke epilepsy
  • Post-traumatic epilepsy
  • Rasmussen’s Encephalitis
  • Temporal lobe epilepsy

Surgeries we perform

  • Corpus callosotomy – complete and partial
  • Extra-temporal lobe resections
  • Hemispherotomy, hemispherectomy
  • Invasive subdural grid and strip and depth electrode placement for seizure localization
  • Lesional resections
  • Selective mesial temporal lobe resection (amygdalohippocampectomy)
  • Temporal lobe resections
  • Tumor resections
  • Vagus Nerve stimulation