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Epilepsy in Children: Treatment, Procedure, Cost and Side Effects

Last Updated: Nov 20, 2024

What is the treatment?

Epilepsy or seizures in children is not very common and can be caused by a genetic disposition for epilepsy that the child is born with. Other causes include illnesses, head trauma and lack of oxygen to the brain. However, there are many cases in which the cause of the epilepsy in children cannot be identified. The risks of epilepsy in children are very high. This is becasue in a state of seizure, children may end up doing things that can cause harm to their own being since they cannot control their own actions in this state. Besides severe attacks of seizure can also cause brain damage in children and present academic and social disadvantages for them. Hence, treating epilepsy in children is extremely important. When it comes to treatment options for epilepsy in children, the commonest form is the administration of oral medications that help in controlling the intensity and frequency of seizure attacks. Usually, these medications are enough to manage the symptoms of epilepsy. However, in severe cases, where medications fail to control the symptoms of epilepsy, doctors may prescribe an epilepsy brain surgery. That said, this is used as a sort of a last resort, and the child has to go through thorough assessment before surgey to make sure if the surgery can stop or reduce the seizures without causing any other type of health problem to the child.

How is the treatment done?

There are 20 different types of medications used to treat epilepsy in children. The doctor may prescribe any one of them depending on the particular case of the child concerned. These drugs have to be consumed orally by the child. Setting a daily schedule for the taking of the medicine by the child is very important. Parents should try to make sure that their child does not miss even a single dose. As for epilepsy brain surgery, these are of many types and involve different procedures, which have been listed below- Lobe resection- In this surgery, the temporal lobe of the patient is cut away with the help of surgical instruments to put an end to the seizures. Post surgery, the area is sutured up. Lesionectomy- This surgery focusses on the removal of the brain lesions, more specifically tumors or malformed blood vessels, which are responsible for giving rise to seizures. Corpus Callosotomy- This is also known as split brain surgery, and in this surgery, the doctor removes a part of the brain known as the corpus callosum. This si generally recommended for children with a very extreme form of epilepsy. Functional Hemispherectomy- In this operation, the surgeon disconnects one hemsiphere of the patient's brain from the other, and also removes a part of the brain tissue. Multiple Subpial Transection- In this procedure, the surgeon will make several shallow incisions in the patient's brain tissue, which help stop seizures. Vagus Nerve Stimulation- This surgery involves the placing of a device under the child's skin, which helps control as well as lower the intensity of seizures. Responsive Neurostimulation Device- In this procedure too, a neurostimulator (which is a type of device) is placed into the patient's skull, right under the scalp. This can help stop seizures. The surgery a child is prescribed will depend on his case.

Who is eligible for the treatment? (When is the treatment done?)

Any child who suffers from epilepsy is an eligible candidate for medication. Surgery is only reserved for very severe cases.

Who is not eligible for the treatment?

Children whose epilepsy can be controlled via medication need not undergo surgery.

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Are there any side effects?

Epilepsy drugs for children carry a few side effects such as double vision, rashes, grogginess, dizziness, unsteady feet and nausea. Epilepsy brain surgeries also come with risks such as bleeding and infection, worsening of the existing problems, loss of vision, stroke, paralysis, speech problems, loss of motor skills as well as a return of the seizures.

What are the post-treatment guidelines?

Talking about drugs for epilepsy children, there are no post-treatment guidelines as the child may have to be on medication for all his life. When it comes to epilepsy brain surgery, the post-treatment guidelines can vary depending on the type of surgery that has been conducted. However, general guidelines include bed rest, not washing the hair or head, not taking stress, not lifting heavy objects or indulging in strenuous activities till the doctor permits.

How long does it take to recover?

Since medications for epilepsy have to be taken for life, there's no recovery period as such. As for surgery, the recovery period is quite long and it can take a couple of months (up to three) to go back to a normal life. Anti-seizures will have to be continued post-surgery as well, at least for a couple of years.

What is the price of the treatment in India?

The cost of epilepsy drugs starts from around Rs 15 per tablet and can go up to Rs 10,000 for a pack of tablets. As for epilepsy surgery, the total cost can go up to Rs 2.5 lakhs in the country.

Are the results of the treatment permanent?

There is no cure for epilepsy. Hence, the results of either the drugs or the surgery cannot be called permanent. However, both of these can greatly help in managing the symptoms and in improving the quality of life of the affected child.

What are the alternatives to the treatment?

Apart from medications and epilepsy brain surgery, parents can choose another treatment option for their child, which is the following of a ketogenic diet. This diet is higher in fats and contains low levels of carbohydrates when compared to an ordinary diet. This treatment is offered when drugs cause too many side effects and surgery is not a viable option.

References

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Written ByDr. Arun Sharma MBBS,MS - General Surgery,MCh - Neuro SurgeryNeurology
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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