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Treatments for Epilepsy in Children

Epilepsy and Vagal Nerve Stimulation (VNS)

VNS is a newer type of treatment for people with seizures who haven't had success with medication and are not candidates for epilepsy surgery. In some ways, it's conceptually similar to a pacemaker for people with heart problems. VNS involves implanting a small device about the size of a silver dollar in the chest. It is attached by small wires under the skin to the vagus nerve, a large nerve in the neck, and programmed to regularly emit pulses of electricity to the nerve every few minutes.

Exactly why the device works isn't entirely known, but these regular pulses of electricity help many people with epilepsy reduce the frequency or intensity of their seizures. The device can also be triggered manually by a magnet that can be worn on the wrist or belt. If a person feels a seizure coming on, he or she can wave the magnet over the device to cause it to immediately deliver an electric charge. Parents could also use the magnet on their child after a seizure has begun.

The most common side effect of VNS is hoarseness and, less commonly, discomfort. It may also cause a person's voice to change during the few seconds of stimulation (for that reason, people sometimes turn it off before singing or public speaking). A doctor will be able to reprogram the device in the office using a computer, and you shouldn't need any further maintenance until the battery runs out, which will probably be about six to eight years.

VNS doesn't cure epilepsy but, like anti-seizure medicines, in most people it helps reduce symptoms. Usually, a person using VNS would still take medication, although probably in smaller doses.

The Future of Epilepsy Treatment in Children

"Obviously, we want a cure," says Turk, "but we just don't have one yet. The closest thing we have to a cure for children is the hope that they will go into remission on their own as they get older."

But while a cure for epilepsy isn't imminent, progress in treatment is making a difference. Turk is optimistic that more funds for epilepsy research in recent years will bring success. Advances have already been made in the development of new technology to treat epilepsy and assist in the surgical evaluation.

Some other promising work has been in the genetics of epilepsy. Researchers are beginning to learn how different types of the disease are inherited. Eventually, a better understanding of genetics could lead to more targeted and more effective treatments for the different varieties of seizures.

Solomon L. Moshe, MD, director of Clinical Neurophysiology and Child Neurology at Albert Einstein College of Medicine in New York, believes that a major breakthrough will be the development of drugs that are specifically designed for children. Because it's harder to research drugs in children, kids with epilepsy wind up getting drugs that were really designed for adults. Researchers are confirming that childhood epilepsy is significantly different from adult epilepsy. The next step is to make drugs specifically for children.

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