Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
The main line of treatment is with antiepileptic drugs,
which are effective in controlling seizures in 70%-80% of patients with epilepsy.
There are several antiepileptic medications. Since certain medications are much
better for some seizures, the choice of the medication should be made by a
physician who is familiar with these medications. If possible, the child should
be evaluated in a center specializing in epilepsy. If this is not feasible,
usually pediatric neurologists have training in epileptic disorders and are a
good source for a referral.
When antiepileptic drugs fail to control the seizures, the patients may
improve with surgical procedures.
Who is a candidate for epilepsy surgery?
Surgery is indicated in a small group of children.
It usually takes the failure of two or three
antiepileptic medications before a child would be considered as a potential
candidate for surgery. In general, this happens at least after two or three
years of continuous treatment with medications. The failure might be due:
to a
resistance to the antiepileptic
medications that are available,
to the presence of intolerable side effects to
the antiepileptic medication,
or to a combination of both.
Since surgical
procedures might be very effective in some children, once it is clear that the
child's epileptic disorder is not responding to treatment with antiepileptic
medications, surgery should be considered. Young age is not a contraindication
for surgery, and there is no benefit in waiting for the child to be older. In
fact, there is considerable evidence that the younger a child is at the time of
surgery, the better his/her potential will be for good function after the
surgery. There is a certain degree of plasticity in the brain that helps with
the recovery of functions that can be damaged at the time of surgery. This
plasticity is higher in younger than in older children.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Genetic disease is a disorder or condition caused by abnormalities in a person's genome. Types of genetic inheritance include single inheritance (for example, cystic fibrosis, sickle cell anemia, Marfan syndrome, and hemochromatosis), multifactoral inheritance, chromosome abnormalities (for example, Turner syndrome, and Klinefelter syndrome), and mitochondrial inheritance (for example, epilepsy and dementia).
Seizures are divided into two categories: generalized and partial. Generalized seizures are produced by electrical impulses from throughout the brain, while partial seizures are produced by electrical impulses in a small part of the brain. Seizure symptoms include unconsciousness, convulsions, and muscle rigidity.
Febrile seizures, or convulsions caused by fever in small children or infants can be frightening, however, in general are harmless. Febrile seizures is not epilepsy. It is estimated that one in every 25 children will have at least one febrile seizure. It is important to know what to do to help your child if he/she has a febrile seizure.
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