Helping Children Who Struggle with Seizures
Seizures in children are a frightening experience for a child and his or her family. At the Seizure & Epilepsy Program at Floating Hospital for Children in Boston, we understand. Our team of top doctors excels in finding the cause of your child's seizure(s), including epilepsy, and minimizing such incidents in the future.
Our program cares for patients ranging from the fetal stage through 19 years who have had seizures or have epilepsy. We primarily see patients at our downtown Boston location, but also take appointments twice monthly at MetroWest Medical Center. In addition, we collaborate with Lawrence General Hospital for EEG consultation. Our program, as well as the Pediatric Encephalography Laboratory, is under the direction of Dr. Ju Tang, MD, PhD, who trained at Beijing Medical University, Miami Children’s Hospital, Massachusetts General Hospital, and Boston Children’s Hospital before coming to Floating Hospital for Children.
The National Association of Epilepsy Centers has recognized Tufts Medical Center as a Comprehensive Epilepsy Level 3 Center. This designation signifies that we have the "professional expertise and facilities to provide the highest level medical evaluation and treatment for patients with complex epilepsy."
What's Causing Your Child's Seizures?
During your first visit, we discuss your child's seizure(s) with you and perform a thorough physical and neurological examination. If your child has not already been diagnosed with epilepsy or another seizure disorder, we'll order tests.
Our team is highly skilled in conducting electroencephalogram (EEG) tests, which measure electrical activity in the brain and are helpful in confirming a diagnosis of epilepsy. If further testing is necessary, we may refer you to Tufts MC experts in magnetic resonance imaging (MRI) of the brain.
We also offer a long-term monitoring service, in which you and your child stay an average of two days in the hospital. This allows us to capture the seizure episodes and gather more information during the episodes to enhance diagnosis and management.
Our specialized experience allows us to make diagnoses where others cannot. Furthermore, Program Director Ju Tang MD, PhD also sees patients with Sleep Disorders, which gives us an advantage in distinguishing sleep disorders from seizure disorders.
Managing Seizures in Your Child
We work with you to determine the best treatment option for managing seizures in your child. Our most common approach is anti-seizure medications, which are often successful in managing seizures.
If medications do not help your child, we may consider options such as:
- Ketogenic diet: This special high-fat, low-carbohydrate diet helps control seizures in some people with epilepsy. It must be administered under professional guidance. We admit your child to initiate the treatment, observe him or her to confirm it is working safely and follow your child closely after discharge.
- Vagal nerve stimulation: This is another form of treatment that may be tried when medications fail to stop seizures. It involves implanting a pacemaker under the skin that sends small electrical pulses via the vagus nerve to the brain.
- Surgery: If we determine surgery to be the best option for preventing your child's seizures, we'll refer you to an epilepsy center with proper surgical expertise.
- Experimental therapies: Your child may benefit from taking part in a clinical trial offering access to promising new therapies. Participation is voluntary, of course.
If we can get your child's seizures under control, we'll continue to see him or her every three months and eventually every six months. More frequent visits will be necessary if his or her seizures begin occurring more often.
Follow-up for seizure management is very important. We need to monitor certain symptoms that may relate to the seizure or are potential side effects of antiepileptic medications. With some medications, we'll need to check blood tests to ensure proper medication levels. As your child grows and gains weight, we also need to adjust medication dosages.
How involved will I be in my child's care?
Your involvement is absolutely essential. We look to parents to monitor for possible triggers for seizure episodes (e.g. fever, lack of sleep), to administer the medications properly and to enforce certain precautions (e.g. ensuring your child does not swim or bathe alone).
What support services do you offer parents?
We don't want you to deal with your child's medical challenges on your own. Our team takes great care to educate you on all aspects of your child's condition and seizure management. Floating Hospital social workers can connect you with counseling and other resources. And many parents take advantage of services available through the Floating Hospital Center for Children with Special Needs.
How prevalent is childhood epilepsy?
By 20 years of age, one percent of the population can be expected to have developed epilepsy. Children in certain populations are at higher risk. For example, it is estimated that epilepsy develops in:
- 25.8% of children with mental retardation
- 13% of children with cerebral palsy
- 50% of children with both disabilities
- 8.7% of children of mothers with epilepsy
- 2.4% of children of fathers with epilepsy
- 33% of people who have had a single, unprovoked seizure
What causes epilepsy?
Despite growing knowledge of causes, no cause can be found in about seven out of 10 children with epilepsy. However, when seizures start, your physician will work with you and your child to try to identify any potential underlying causes. The cause may be one of any number of things that can make a difference in the way the brain works.
The main potential causes of epilepsy include:
- Brain malformations
- Lack of oxygen during or before delivery or at birth
- Electrolyte disturbances (e.g. low blood sugar or calcium)
- Chemical disorders (a.k.a. inborn errors of metabolism)
- Bleeding or stroke in the brain
- Infections (e.g. meningitis)
- Head trauma
- Ingestion of poisonous substances
- Genetic factors (e.g. tuberous sclerosis)
- Brain tumor (rarely)
The Epilepsy Foundation is a great resource for parents of children with epilepsy.
If you refer a patient to us for evaluation, we'll make every effort to see him or her as soon as possible. If the child remains under our care, we'll update you as necessary on our management plan following each appointment.