Pediatric Surgical Epilepsy Program

About 10% of children with epilepsy have seizures that can’t be controlled by medicine and get worse over time. Surgery is often the best treatment option for these children, because it can stop their seizures, or reduce them and the need for medication. Children’s Health℠ is a national leader in state-of-the-art epilepsy surgeries that can put your child on track toward a happier, healthier future.

Treatment plans tailored to your child

Children’s Health offers care from a team of renowned UT Southwestern doctors – including epileptologists, neurosurgeons, neuropsychologists and radiologists. These experts work together to evaluate your child to determine if surgery is their best treatment option. Then, they build a customized surgery plan that’s tailored to your child.

Our program includes:

• Testing. We use the most advanced testing and tools to pinpoint what’s causing seizures and which part of the brain they’re coming from. Our testing is very rigorous because we want to have a thorough understanding of your child’s condition, so we know how to treat it. Initial testing may include an MRI and EEG, which help doctors evaluate your child’s brain. More in-depth testing may include video EEG, Ictal SPECT, PET scan, surgical tests or evaluations from a neuropsychologist.

• Surgery. If we determine that surgery can help your child, we work together to decide which type of surgery gives them the best opportunity to overcome their seizures. The three types of surgery to treat epilepsy include:

  • Resective epilepsy surgery. Doctors may recommend this type of surgery if the seizures come from one part of the brain that can be safely removed. Our neurosurgeons perform this surgery using advanced techniques. For instance, we are leaders in laser ablation – a state-of-the-art procedure that uses a laser to remove a tiny part of the brain. Many children become seizure-free after a resective surgery.

  • Disconnective epilepsy surgery. If the seizures are coming from a part of the brain that can’t be removed, the doctors may recommend a disconnective surgery. This type of surgery isolates the part of the brain causing the seizures by disconnecting it from the surrounding areas. Some children can become seizure-free after disconnective surgery. Others have significantly fewer seizures after surgery and need less anti-seizure medication.

  • Palliative surgery. Sometimes testing reveals that seizures are coming from so many parts of the brain that resective and disconnective surgeries aren’t possible. In this case, we may turn to palliative surgery, which is designed to treat symptoms and help your child be more comfortable. This type of surgery can help your child have fewer seizures and make those seizures less disruptive.

  • Follow-up care. Following surgery, we provide any care needed to help your child thrive. That could mean continued testing, medication evaluation and neuropsychological therapy.

Comprehensive care from an expert team

At Children’s Health, our experts work together throughout your child’s testing and treatment journey to provide the highest level of care.

For example, our team meets weekly to review each child’s case. At the meeting, your child’s epileptologist will present a complete review of the child’s imaging, test results and potential treatment options. They gather feedback from the other epileptologists on our team, neurosurgeons, neuropsychologists and radiologists, and decide on the best testing and treatment plan. This enables us to understand each patient from every angle, so we can figure out which treatment is right for them.

Focused on life-changing outcomes

Our overall goal is to provide a life-changing outcome for your child. When we recommend surgery for your child, we’ll provide a more specific goal for their treatment. The goal may be to become seizure-free, medication-free or to make their seizures far less severe and reduce their need for medication. This will be discussed with you first by your epileptologist, and again by your neurosurgeon if surgery is recommended.

Many of our patients have not had a single seizure after surgery. Some children have seizures during the first few weeks while the brain is healing and then become seizure-free. If surgery doesn’t stop a child’s seizures, it usually reduces them and the seizures are milder. In those cases where the seizures continue, testing is done to see if there are other treatments that can be used.

Care throughout childhood

Our priority is to ensure that your child has the highest quality of life. If your child needs it, we continue customized care for their epilepsy throughout childhood.

Following surgery, our team will continue working together to ensure your child’s case is reviewed by all experts. Your child will continue to have check-ups with an epileptologist, who will prescribe any follow-up treatments that might be needed, like neuropsychological therapy, testing and medication.

Resources

This online, interactive guide is for parents and families thinking about pediatric epilepsy surgery at the Comprehensive Epilepsy Center of Children's Health℠.

• A Parent's Guide to Pediatric Epilepsy Surgery

If you wish to print any of the information, please use the links below:

• Grids and Strips Surgery (PDF)

• Hemispherectomy Surgery (PDF)

• Resection Surgery (PDF)

• Understanding Epilepsy (PDF)

• Teen Guide to Epilepsy Surgery - English (PDF)

• Teen Guide to Epilepsy Surgery - Spanish (PDF)