Comprehensive Epilepsy Program

Why Riley Children's for Epilepsy Care

Riley Children's has the only Level 4 Comprehensive Epilepsy Program in Indiana as defined by the National Association of Epilepsy Centers (NAEC). Level 4 programs like ours have enhanced imaging techniques, clinical experts and innovative technology to perform advanced medical and surgical evaluations for patients with medically refractory epilepsy – epilepsy that’s hard to manage with medications. Our multi-disciplinary program is comprised of:

• Pediatric epileptologists (epilepsy specialists)
• Neuropsychologists
• Pediatric neurosurgeons
• Dietitians
• Social workers
• Neurophysiology technicians
• Geneticists

We diagnose and manage new-onset pediatric and teenage epilepsy. Our providers are experts in hard-to-treat intractable epilepsy. The Comprehensive Epilepsy Program is actively involved in epilepsy research and continues to innovate minimally invasive epilepsy surgery. Our team will work to find treatments that will control or reduce your child’s seizures.

Our program uses a wide range of expert knowledge to treat all types of epilepsy. These range from the most common to more rare forms, including:

Focal epilepsy syndromes due to:

• Structural brain malformations (stroke, hypoxic ischemic encephalopathy, hemimegalencephaly)
• Low-grade tumors
• Malformations (focal cortical dysplasia, heterotopias, schizencephaly)
• Mesial temporal sclerosis
• Neurocutaneous syndromes (tuberous sclerosis and Sturge-Weber syndrome)

Generalized epilepsy syndromes, including:

• Absence seizures
• Atonic seizures
• Genetic epilepsy syndromes
• Lennox-Gastaut syndrome
• Myoclonic seizures
• Tonic seizures
• Tonic-clonic seizures

Diagnosing epilepsy

Our board-certified pediatric neurologists and fellowship-trained epileptologists are trained to treat epilepsy and seizures. They work with other doctors and nurses who are specialists in general pediatric neurology, neurosurgery and nutrition. They will work together to find the best treatment plan for your child.

What is medically refractory epilepsy?

Medically refractory epilepsy is defined as continued seizures despite effective doses of multiple medications. The chances of these patients being cured with medications are less than 3%.

Neurological Surgery in these patients is far more effective and less dangerous than continued ineffective medications. These patients undergo what’s called “Phase 1.” In this phase, noninvasive pre-surgical data is collected including:

• Medical history & physical exam
• Video EEG (VEEG)
• Structural and functional neuroimaging
• Neuropsychology testing

This data is evaluated by a pediatric epileptologist and presented to the Comprehensive Epilepsy Program team. A care plan is then developed which could include:

• Further testing
• Medications or diet therapies
• Surgery

What to Expect at Riley Children's

Our program coordinator ensures efficient timing for tests during the Phase 1 evaluation. We provide families with training in managing epilepsy. We also educate families on using dietary therapies, including the modified Atkins and ketogenic diets.

Our monitoring unit

We provide a five-bed monitoring unit to study patients and gain more information about your child's seizures. Patients who are being evaluated for surgery may also stay in this unit. The epilepsy specialists (epileptologists) use prolonged video electroencephalogram (VEEG) to better understand each patient’s seizure type and epilepsy syndrome. This information assists the patient’s neurologist in making appropriate treatment decisions.

Your child's epilepsy care plan

As part of this comprehensive approach, patients see a neurosurgeon and epileptologist together following the Phase 1 evaluation to discuss your child’s care plan. This one visit provides increased convenience for patients and their families. The program also supports patients over time as children grow to ensure continued seizure freedom. A complete modern approach to epilepsy surgery is offered.

We are happy to discuss this evaluation with you or your child’s primary care doctors throughout the process. Many patients will be good candidates for epilepsy surgery. When patients are not indicated for surgery, or following the initial post-surgical period, patients continue to be managed by the referring provider.