NAEC Level 4 Seattle Children's Epilepsy Program provides promising options for children with epilepsy. We have the largest epilepsy program on the West Coast and have been designated by the National Association of Epilepsy Centers (NAEC) as the only Level 4 accredited program dedicated to treating children in the Northwest. Our program is part of the University of Washington Regional Epilepsy Center. Seattle Children's is a leader in treating children who have just been diagnosed with epilepsy and those whose seizures cannot be controlled by medicines. Our team includes experts in epilepsy, neurosurgery, neuropsychology and neuroradiology as well as specially trained nurses and staff. We see children at our outpatient clinics, and we have a special area in the hospital for monitoring children's brain activity. We also have a technologically advanced operating suite. We are active in research and take part in clinical trials of treatments for epilepsy.

Conditions We Treat

We see children with a broad range of neurological conditions that involve seizures, including:

  • Children with BRE have seizures that cause twitching, numbness or tingling in the face or tongue. The seizures, which usually last no more than two minutes, can cause drooling and problems with speech. They also can spread and become generalized seizures. About 15% of children (about three in every 20) with epilepsy have BRE. It is the most common cause of seizures in school-aged children. Many children do not take any seizure medicines for the condition.

  • Epileptic encephalopathies (en-seff-uh-LAW-path-ees) are severe brain disorders in which problems are at least partly caused by epileptic activity over time. Landau-Kleffner syndrome, for example, is a rare disorder that causes children to lose the ability to speak. Children with Landau-Kleffner syndrome often have seizures while they are sleeping. Rasmussen's syndrome causes a slow loss of function on one side of the brain. The affected side of the brain can cause seizures and weakness on the opposite side of the body.

  • Cortical dysplasia happens when tissue in part of a brain called the cerebral cortex does not develop properly before a baby is born. Patches of this abnormal brain tissue cause seizres and developmental delays. Cortical dysplasia is a common cause of epilepsy.

  • Mitochondria in cells help make almost all of the energy people need to live and grow. In children with mitochondrial disorders, these energy-making areas do not work as they should. This damages cells and causes different kinds of symptoms, depending on which cells are damaged. Epilepsy can happen to children with some kinds of mitochondrial disorders.

  • Some types of epilepsy may be caused by problems in genes. There are many epilepsy syndromes in children that are caused by genetics. These include tuberous sclerosis complex, in which tumors grow in the brain and other organs. The tumors can affect the central nervous system. Another genetic epilepsy, Dravet syndrome, often is caused by problems in a gene that usually helps brain cells work as they should.

  • Generalized tonic clonic seizures used to be called grand mal seizures. The seizures include a tonic phase — muscle stiffening, crying or groaning and passing out (loss of consciousness). This is followed by the clonic phase — arms and legs jerking quickly and rhythmically. These seizures generally last from one to three minutes. If they last longer, they usually require emergency treatment. Generalized tonic clonic seizures affect both children and adults. They are usually controlled with medicine.

  • Infantile spasms are a type of seizure. They happen during infancy and childhood, and are part of an epilepsy syndrome called West Syndrome. The spasms often come in clusters of 100 or more. Children with infantile spasms may have several hundred spasms a day.

  • Intractable epilepsy is an ongoing, or chronic, condition. It can severely affect a child's physical, social and emotional development. Children with intractable epilepsy have seizures that cannot be controlled by medicines alone.

  • Children with JME have mild seizures with quick jerks of the arms, shoulders or occasionally the legs. These myoclonic jerks sometimes are followed by a tonic clonic seizure. Children may also seem to blank out for a few seconds to several minutes. Most JME seizures can be controlled with medicine.

  • Pyridoxine-dependent epilepsy is caused by changes in a gene. Children with pyridoxine-dependent epilepsy have seizures that last several minutes. People with this form of epilepsy are often treated with large doses of pryidoxine, a kind of vitamin B6.

Services We Provide

  • Neuroimaging procedures make high-quality pictures of the structure and functioning of the brain. MRI (magnetic resonance imaging) provides very detailed chemical and physical information about the brain. PET (positron emission tomography) shows parts of the brain that are using less energy. This can sometimes help identify the source of seizures. SPECT (single photon emission computed tomography) measures tissue changes and provides information about blood flow. Advanced technology at Seattle Children’s allows us to use and integrate information from these images. This makes diagnosing your child’s epilepsy more accurate and improves care.

  • In brain mapping, doctors place electrodes on many parts of your child’s brain. These electrodes can help find where seizures start. They also identify critical parts of the brain, such as those responsible for talking and moving.

  • During a comprehensive evaluation, we monitor the electrical activity in your child’s brain. We do this using audio-visual-electroencephalogram (EEG) technology. Your child stays in our epilepsy monitoring unit for about a week. During that time, we can see patterns of behavior and movement and use EEG to record seizures. This can help us find the source of seizures. We also use brain imaging techniques such as MRI, PET and SPECT scans. These images, along with neuropsychological testing, help us to find out more about your child’s seizures and ability to function.

  • Seattle Children’s Neurology team offers a clinic for children who have had a seizure for the first time. At your clinic visit, a nurse practitioner evaluates your child and talks with you about seizures. In one or two days your child comes back for an EEG (electroencephalogram, a painless recording of the brain’s electrical activity). Some children return to the clinic after seeing a neurologist and epilepsy specialist. Your referring provider or your team at Children’s may ask you to bring a home video of your child having a seizure (if you have a video) and a log of your child’s seizures when you come to the clinic.

  • Medicine for treating seizures may not work for all children. Some children may benefit from nutrition therapy.

    Neurologists may use the ketogenic diet or the modified Atkins diet to lessen or stop a child’s seizures. The ketogenic diet team will help you decide if this is the right choice for your child. If it is, your child may begin the ketogenic diet or the modified Atkins diet. If the diet is effective, some children are able to decrease the number of antiseizure medicines that they take.

    Our ketogenic diet program serves a diverse group of patients across the Pacific Northwest, from early childhood to 18 years of age.

    Ketogenic diet

    The ketogenic diet restricts many foods that your child eats. The diet includes eating foods that are high in fat and very low in carbohydrates and proteins.

    In general, children following a ketogenic diet must avoid:

    • Starches
    • Grains
    • Sugars
    • Most fruits and vegetables

    The ketogenic diet team will make sure your child is receiving nutrients to grow and maintain a healthy weight. All meals and snacks must be weighed on a scale, and recipes are often planned in advance.

    To start the ketogenic diet, your child will be admitted to the hospital and closely cared for by the ketogenic diet team while they adjust to their new diet.

    Once on the diet, your child will have routine follow-up appointments to make sure they are tolerating it well. Many children are on the diet for 2 or more years. Children on this diet should always be under a doctor’s care.

    Modified Atkins diet

    The modified Atkins diet (MAD) can also help control seizures. It includes eating foods that are high in fat and very low in carbohydrates.

    Unlike the ketogenic diet, children do not need to be admitted to the hospital to start the diet, and it does not require that food be measured with a scale. Children on this diet should always be under a doctor’s care.

  • This treatment uses light to heat and destroy unwanted cells, including lesions that can cause epilepsy. It may be a good choice, and even a cure, for children who have few or no other treatment options, either because medicine doesn’t control their seizures or their lesions are deep and hard to reach with open surgery. Seattle Children’s is the only pediatric hospital in the Pacific Northwest, and one of only a handful of centers in the country, to offer laser ablation for epilepsy. Read more.

  • This evaluation is one way to look at your child’s brain development. Although other tests look at other aspects of the brain (for example, an EEG looks at electrical activity and an MRI looks at structure), this testing looks at the way the brain is linked to behavior. We measure memory, attention and language skills, to name a few. Read more. (PDF)

  • To help ensure the best treatment results, our team offers evaluations of medicines your child may use to control seizures.

  • Vagus nerve stimulation is an alternative to brain surgery. The vagus nerve starts in the brainstem. From there it goes down the neck and into the chest. The vagus nerve stimulator delivers a small, on-and-off electrical current to the vagus nerve. This helps prevent seizures.

  • We have a special area in our hospital devoted to monitoring children’s brain activity. Using video and EEG (electroencephalogram) equipment, we look for clues to their seizures. An EEG is a painless recording of the brain’s electrical activity.

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