Pediatric Epilepsy Program

Nemours Children's provides the latest care for all types of epilepsy and seizures, including hard-to-treat refractory epilepsy, or seizures that don’t respond to medicines. No matter where your family is in your epilepsy journey, we help guide you to the next right thing. We base our treatment on your child’s and family’s goals.

We offer a range of services and treatment options:

• Advanced diagnostics, including the safe, accurate neuroimaging and 24/7 EEG testing at state-of-the-art Epilepsy Monitoring Units (EMUs).
• Ketogenic diet counseling from registered dietitians to help control seizures.
• Neuromodulation therapies like vagus nerve stimulation (VNS), responsive neurostimulation (RNS) and deep brain stimulation to help reduce seizure frequency and duration.
• Epilepsy surgery from neurosurgeons who use highly advanced image guidance system for the best possible outcomes.
• Neuropsychology services from specialists who know how seizures can affect a child’s thinking and behavior.
• Education and support for daily living, including sick day care plans and seizure action plans you can share with your child’s school.
• Specialized programs for kids with seizures related to complex conditions like tuberous sclerosis and neurofibromatosis.
• Services and support from a team of care coordinators, social workers, Child Life specialists and others who help your family navigate care, cope with a diagnosis and find resources in your community.
• Help with transition to adult epilepsy care.

For some children, a stay in our Epilepsy Monitoring Unit (EMU) is needed to gather more information about their brain activity. This continuous EEG monitoring provides valuable insights that help us accurately diagnose epilepsy and tailor your child's treatment plan.

What to expect during an EMU stay:

• An EEG technologist will attach electrodes to your child's scalp to continuously record brain activity.
• You'll stay with your child throughout the entire visit, typically lasting one or more nights.
• Our team, including Child Life specialists, will ensure your child stays comfortable and engaged with age-appropriate activities.
• The study concludes once we've collected sufficient data, usually with discharge in the late morning.

This extended monitoring in a controlled environment allows us to capture crucial information about your child's brain activity. It can us provide the most effective care for their specific type of epilepsy.

For some kids with hard-to-control epilepsy, our team may recommend specialized dietary therapy, such as the ketogenic diet. This high-fat, low-carbohydrate diet can help reduce or even stop seizures in some cases.

Here's what to expect:

• You'll meet with our specialist and dietitian to discuss if this therapy is right for your child.
•  If recommended, your child will be admitted to the hospital for a few days to start the diet safely.
• Our dietitian will create a personalized meal plan for your child.
• You'll receive training on preparing keto meals and monitoring ketone levels.
• We'll closely monitor your child's response to the diet and make necessary adjustments.
• Regular follow-up appointments and blood tests will be scheduled.
• Our team will provide resources, recipes and support for managing the diet at home and school.
• The diet is typically tried for several months and may continue for about two years if effective.
• We'll support you throughout the process from the start to potential transition off the diet.

While the ketogenic diet can be challenging, many families find the effort worthwhile when it improves their child's seizure control. Our team is here to support you every step of the way.

VNS therapy is an advanced treatment option for certain types of epilepsy that don't respond well to medication alone. Here's what you can expect if your child is recommended for VNS therapy:

The procedure is usually done as same-day, or outpatient, surgery.

• Your child will receive anesthesia to ensure comfort.
• The surgeon will make a small cut in the chest to implant the generator device.
• Wires will be threaded from the generator to the left vagus nerve in the neck.
• The incision will be closed with a few stitches and covered with a bandage.
• Most children go home the same day as the surgery.
• A few weeks after surgery, we'll activate and program the device.
• We'll teach you how to use the device, including the handheld magnet for seizure control.