Pediatric Epilepsy

It is sometimes caused by an underlying disease, injury or brain development disorder, but it often seems to appear out of nowhere. A child may have epilepsy if they have had two or more unprovoked seizures, meaning there is no detectable immediate cause of the seizures such as a high fever. Epilepsy can involve many different types of seizures: Epilepsy sometimes can cause changes in behavior and personality or lead to other neurological problems, learning difficulties, or depression and anxiety. Identifying these sorts of problems and intervening early are important aspects of caring for a child with epilepsy.

Most children with epilepsy can achieve good seizure control with treatment, and some can live seizure-free. A new technique, noninvasive brain stimulation, is also being studied.

Finding a treatment approach that works for your child can involve some trial and error. CiteScore values are based on citation counts in a given year e. View More on Journal Insights. Your Research Data Share your research data Visualize your data. Publishing your article with us has many benefits, such as having access to a personal dashboard: This free service is available to anyone who has published and whose publication is in Scopus. Researcher Academy Author Services Try out personalized alert features.

Introduction

Tuberous sclerosis complex diagnostic criteria update: Recommendations of the international tuberous sclerosis complex consensus conference - Open Access Hope Northrup Darcy A. De Vries Vicky H. Recent Articles Recently published articles from Pediatric Neurology. Most Cited Articles The most cited articles published since , extracted from Scopus. A ketogenic diet KD can be an alternative medical treatment for these children. Wilder reported significant seizure control effect of the KD at first [ 2 ].

The KD is composed of high fat, moderate protein and restricted carbohydrate and it results in a state of ketosis. To maintain strong ketosis state, 4: In order to maintain the 4: Incorporating high amount of fat into the diet is the main challenge to proceeding the KD.

How we care for epilepsy

A child suffering with epilepsy is usually to initiate the KD. In our hospital, a KD team is composed of a physician, a registered nurse, and a registered dietitian. During the diet, the physician evaluates and manages complications of KD. Right after the physician, the head of the team, decides to start the KD program, the dietitian provides nutritional management to maintain the KD, and the nurse examines child for tolerance toward the KD diet and educate caregivers how to care child with the KD at home.

Frequent communications between caregivers and the KD team are necessary to continue the KD program. Our KD program starts without initial fasting.

Total fat contents in a patient's meal is gradually increased within 3 days. Before starting the KD, the dietitian evaluates the nutritional status of the child at the initial day and evaluates his or her ability to take food, activity level and growth pattern such as current height, weight and weight change. For the meal planning, the dietitian has to decide nutritional requirement of energy and nutrient distribution.

Protein can be adjusted by child's current weight. For general case example, a meal plan for a five-year-old child, with cm, 18 kg, PIBW This goal is achieved by meals composed of g of fat, 18 g of protein and 12 g of carbohydrate per, which makes the ratio of fat g to nonfat 30 g is 4: Then these amounts from each nutrient is divided by the numbers of meal supply.

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The carbohydrate-rich foods such as rice, bread, grain and simple sugars are eliminated. One food is selected from each food group which is categorized to either meat, fish, vegetables, milk or fat sources. The amounts of each food are calculated in grams and the content of nutrients are analyzed to achieve a desired ratio based on the individual nutrient requirement. It is not easy for caregivers to calculate the amounts of each food in grams by themselves. For their convenience, the KD team provides them a computer program to calculate accurate amounts of foods and nutrients contents to minimize human errors.

After calculation, the proportions of carbohydrate, protein, fat in calories, the desired ratio, and nutrient requirement of a patients are confirmed Table 1.

The meals are provided in accurate amounts by weighing food with digital precision scale. Ketogenic diet, Total calories: In order to achieve the ideal ratio, more fat from vegetable oils is needed not only from foods but also from others. In our hospital, we usually supply olive oil as a main fat source.

In order to improve the composition of fatty acids, we combine olive oil with sesame oil, perilla seed oil, canola oil and others. We also provide nuts in order to improve flavor of meal and reduce the amount of vegetable oils. In our hospital there are three basic types of formulation; all-in-one, separated and semi-separated types.

All-in-one type is a blended or pureed form for the children at initial stage of the KD, and also for children who have difficulties in chewing and swallowing.

• Epilepsy in Children | Boston Children's Hospital.
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