Each child comes to the South Texas Comprehensive Epilepsy Center (STCEC) with a unique set of medical conditions. [link to conditions page] We conduct numerous neurological assessments to determine the type, intensity, frequency and origin of seizures. This information allows us to create individual treatment strategies for epileptic children of all ages.
Getting an accurate diagnosis is key. Many of our patients undergo three-to-five days of observation in our high-tech, pediatric epilepsy monitoring unit at University Hospital, where brain wave data is recorded during controlled seizures and during non-seizure periods for comparison and analysis.
Electrical brain activity is carefully reviewed along with the results of numerous other diagnostic tests [link to testing & diagnostics page] to help our neurologists determine the best course of treatment. Multiple, pediatric epilepsy experts collaborate to reach a consensus on the least invasive treatment that will lead to a positive, long-term outcome for your child.
At University Health System, our number one goal is to improve the quality of life for our patients. Treatments are aimed at controlling seizures – by stopping them completely or in complex cases minimizing the number and severity of the seizures.
Surgical procedures range from removal of a specific targeted portion of the temporal lobe where unwanted brain cell impulses are found to a hemispherectomy, in which half of the brain is taken out. Surgery can be a good treatment option for children who have seizures that originating in a certain area of the brain as opposed to seizure activity found in multiple areas. Our epileptoplogists help families with children who have ongoing, uncontrollable seizures.
After comprehensive analysis, a detailed care plan is developed for each patient to address their medical needs. Our surgeons, stereotactic neurosurgeons, neuropsychologists, psychiatrists and other members of the epilepsy care team discuss options with the patient and their family members. Potential outcomes, of each treatment therapy, are carefully weighed and reviewed.
While medication is a successful treatment option for many children, approximately 30% can’t be helped with anti-convulsant drugs. Additional treatment may include implantation of neurostimulation devices; resective surgery - removal of brain tissue at the site of a tumor, injury or abnormality or invasive surgeries that involve opening the skull. All treatment options are considered, including the benefits of a ketogenic diet – which can be helpful in preventing certain types of seizures.
We provide some of the most innovative and effective epilepsy surgical treatments for children [link to the landing page] in the nation. From diagnostics to surgery, we deliver patient-centered care and promote a process of shared decision-making.
Our epilepsy center, a partnership program between our Health System and UT Health San Antonio, provides a number of traditional and innovative treatment options for children with epilepsy. Some of our treatment options include:
A patient with generalized seizures, which affects both sides of the brain, may benefit from a corpus callosotomy surgical procedure. The corpus callosum, an area of white fibrous matter, located between the two hemispheres facilitates communication between the two halves. A corpus callosotomy is the partial or complete severing of this middle tract to prevent a seizure from spreading. This type of surgery can be helpful to patients who have atonic seizures – a subcategory of generalized seizures.
Neurologists place grids and strips of electrodes under the skull to pinpoint the origin of seizures in preparation for resective surgery. After the electrodes are put in place, patients are sent to our epilepsy monitoring unit for several days of EEG video monitoring. Patients are observed during controlled seizures to learn more about what functions are affected, the type, duration and location of the overactive electrical activity.
A few days later, surgery is scheduled to remove the electrodes and the area of the brain causing the unwanted electrical activity.
A hemispherectomy is a type of surgery in which the seizure affected area of the cerebral cortex is removed. Patients who have this surgery often experience a significant improvement in seizure control and overall neurological function. Patients who have seizures that affect one half of the brain are potentially good candidates for this procedure.
The RNS® system uses an implanted device to help prevent seizures before they begin, similar to how a pacemaker functions. It monitors brain waves 24/7 and detects abnormal activity that can lead to a seizure. When needed, pulses of stimulation can be sent to trigger brain waves back into normal electrical activity. The device is usually inserted in the bone covering the brain. Small wires are put on top of the brain where seizure activity is dectected. This can help stop a potential seizure from moving to the other side of the brain.
This high-tech, minimally invasive surgical procedure is less invasive than an open resection or lobectomy. A stereotactic laser ablation uses magnetic resonance imaging technology to put a probe in an exact location within the brain. The probe uses a laser to heat up and purposefully damage targeted tissue where seizures are originating.
A temporal lobectomy is a surgical procedure that removes the outer layer of the brain at a focal area of the cortex where seizures are originating.
Vagus nerve stimulation therapy involves the implantation of a neuromodulation device on the left side of the chest. An electrode runs from the device and is attached to the vagus nerve in the neck. The VNS device helps to prevent or minimize seizures by sending a repetitive pulse of electrical engery to the brain. It may be considered for children aged 4 and older. It’s used to treat focal or partial seizures that don’t respond well to seizure medication.