Pediatric Epilepsy

Specialty Area: Epilepsy Center

The epilepsy team at Johns Hopkins believes that we must care for the whole child. An accurate diagnosis must be made and an appropriate treatment strategy must be designed. This can only be done by understanding all of the other medical, psychological, social and educational issues that are involved. The child must thrive within the family, the school and the community.

Our book, Seizures and Epilepsy in Childhood: A Guide, now in its 3rd edition, has become the standard text to help families touched by children with epilepsy. Services that are available to our patients on site and in collaborations include:

• Complete seizure history
• Comprehensive neurological examination
• Neurophysiological tests (routine EEG, outpatient video-EEG monitoring,
  Wada testing)
• Long-Term Video-EEG Monitoring: scalp and intracranial
• Neuroimaging: MRI, MRS, PET, fMRI
• Neuropsychology
• Neurosurgery
• Speech and auditory processing evaluations
• Physical and occupational therapy
• Counseling and support services

Treatment Options:

Pharmacological management – Use and monitoring of the appropriate anti-seizure medications to control seizures without significant side effects.

Diet Therapy – The Ketogenic Diet Program - The high fat, low carbohydrate ketogenic diet has been managed through the Pediatric Epilepsy team at Johns Hopkins since its beginnings in the 1920s. We are the premier center in the world for clinical and research expertise regarding the ketogenic diet, having enrolled approximately 700 children over the past few decades.

We admit approximately four children for the diet monthly after being seen for consultation by one of our physicians in the clinic prior. Patients ranging from infants to adolescents are admitted for a five-day period during which the diet is started and education provided. We are also actively investigating the role of the Atkins diet for epilepsy in a clinical trial for both children and adults.

Zahava Turner, R.D. is our dietician and is responsible for the nutritional aspects of the ketogenic diet. Drs. Eric Kossoff and James Rubenstein are the co-medical directors of the program. Our book, The Ketogenic Diet, provides information for parents and nutritionists.

For more information about our ketogenic diet program and other centers in the United States, please contact Dr. Eric Kossoff at 410-955-4529. For additional information, contact the Charlie Foundation.

Surgery – Removal of regions of the brain that are responsible for seizures while protecting functionally important tissue; corpus callosotomy (surgery that prevents spread of seizures between the hemispheres).

Vagus nerve stimulation – A procedure that does not involve brain surgery where a small pacemaker-like device is surgically implanted below the skin on the upper chest. The device delivers a small electrical current to the vagal nerve in the neck. An impulse continues up the nerve to the brain.

Experimental - Patients may be eligible to enroll in clinical studies that test new medications, new approaches to dietary therapy (Atkins diet), and new surgical approaches involving brain stimulation (Neuropace).