TY - JOUR
T1 - Advanced treatments for childhood epilepsy
T2 - Beyond antiseizure medications
AU - Joshi, Sucheta M.
AU - Singh, Rani K.
AU - Shellhaas, Renée A.
PY - 2013/1
Y1 - 2013/1
N2 - A substantial minority of children with epilepsy have continued seizures despite adequate trials of standard antiseizure medications. To maximize seizure control and thereby optimize their neurodevelopmental outcomes, alternate nonmedication therapies should be considered for these patients. Dietary therapies, including the ketogenic diet and its variations, have been available for years. With a recent resurgence in popularity and expansion of indications, these treatments can lead to freedom from seizures or a significantly reduced seizure burden for a large number of patients. For carefully selected individuals, resective epilepsy surgery may offer the best hope for a cure. For others, palliation may be achieved through additional surgical approaches, such as corpus callosotomy and multiple subpial transections, or through neurostimulation techniques, such as the vagus nerve stimulator. In this review, we present these nonmedication approaches to treatment-resistant childhood epilepsy, with attention to patient selection and the potential risks and benefits.
AB - A substantial minority of children with epilepsy have continued seizures despite adequate trials of standard antiseizure medications. To maximize seizure control and thereby optimize their neurodevelopmental outcomes, alternate nonmedication therapies should be considered for these patients. Dietary therapies, including the ketogenic diet and its variations, have been available for years. With a recent resurgence in popularity and expansion of indications, these treatments can lead to freedom from seizures or a significantly reduced seizure burden for a large number of patients. For carefully selected individuals, resective epilepsy surgery may offer the best hope for a cure. For others, palliation may be achieved through additional surgical approaches, such as corpus callosotomy and multiple subpial transections, or through neurostimulation techniques, such as the vagus nerve stimulator. In this review, we present these nonmedication approaches to treatment-resistant childhood epilepsy, with attention to patient selection and the potential risks and benefits.
UR - http://www.scopus.com/inward/record.url?scp=84873505453&partnerID=8YFLogxK
U2 - 10.1001/jamapediatrics.2013.424
DO - 10.1001/jamapediatrics.2013.424
M3 - Review article
C2 - 23147598
AN - SCOPUS:84873505453
SN - 1072-4710
VL - 167
SP - 76
EP - 89
JO - Archives of Pediatrics and Adolescent Medicine
JF - Archives of Pediatrics and Adolescent Medicine
IS - 1
ER -