Overview

Overview

Cleveland Clinic has one of the largest, most comprehensive programs for the evaluation of medical and surgical treatment of epilepsy in children, managing more than 3,000 children with pediatric epilepsy in our outpatient clinics per year. Our dedicated state-of-the-art Pediatric Epilepsy Monitoring Unit evaluates more than 700 children annually and more than 100 children with severe conditions with epilepsy surgery, making Cleveland Clinic’s Surgical Epilepsy Program one of the foremost programs of its kind in the world.

Our Pediatric Epilepsy Program includes six board-certified pediatric epileptologists, an epilepsy neurosurgeon, pediatric neuroradiologists, clinical neurophysiologists, pediatric neuropsychologists, and a dedicated team of pediatric nurses, nursing assistants and EEG technologists.

Testing for children with epilepsy may include:

Pediatric Epilepsy Monitoring Unit

For children requiring inpatient seizure monitoring, Cleveland Clinic Children’s boasts a self-contained nine-bed Pediatric Epilepsy Monitoring Unit operating 24 hours a day, seven days a week, with features that include state-of-the-art all-digital video-EEG equipment staffed by nurses and EEG technicians specializing in pediatric epilepsy.

Level 4 Epilepsy Accreditation Badge

Clinic's Pediatric Epilepsy Program is accredited by the NAEC as a level 4 epilepsy center. Level 4 epilepsy centers have the professional expertise and facilities to provide the highest level medical and surgical evaluation and treatment for children with epilepsy.

Experience in pediatric surgery & high success rates

Cleveland Clinic was one of the first medical centers in the country to perform intracranial brain mapping and SEEG for pediatric epilepsy.

Advancements of this technique, using three-dimensional computer images of the brain, help physicians determine the precise location of seizure activity. This technology may allow doctors to plan a successful surgery to stop the seizures, offering hope for our young patients struggling with epilepsy.

Only a few medical centers in the country provide the range of care for pediatric epilepsy that is available at Cleveland Clinic. We believe that providing the best medical and surgical care for children goes beyond state-of-the-art equipment and latest techniques. It also means providing care with compassion. We understand your concerns, and we are here to help.

What We Treat

What We Treat

Diseases and conditions

Seizure types

  • Atonic seizures.
  • Auras.
  • Autonomic seizures.
  • Absence seizures (petit mal seizures).
  • Clonic seizures.
  • Eyelid myoclonia with photosensitivity.
  • Focal seizures.
  • Gelastic seizures.
  • Generalized tonic clonic seizures (grand mal seizures).
  • Hyperkinetic seizures.
  • Infantile spasms.
  • Seizures with impaired awareness and automatisms.
  • Sensory seizures.
  • Tonic seizures.
  • Versive seizures.

Epilepsy due to various conditions

Childhood-onset epilepsy syndromes and seizure disorders

  • Acquired epileptic aphasia (landau kleffner syndrome).
  • Childhood absence epilepsy.
  • Focal epilepsy.
  • Frontal lobe epilepsy.
  • Dravet syndrome.
  • Early myoclonic epileptic encephalopathy.
  • Electrographic status epilepticus in sleep (ESES).
  • Epileptic encephalopathy in infancy.
  • Febrile seizures.
  • Genetic epilepsy with febrile seizures plus (GEFS+).
  • Hemispheric epilepsy.
  • Idiopathic childhood occipital epilepsy (gastaut type).
  • Jeavons syndrome.
  • Juvenile absence epilepsy.
  • Juvenile myoclonic epilepsy.
  • Lennox gastaut syndrome.
  • Multifocal epilepsy.
  • Myoclonic atonic epilepsy (doose syndrome).
  • Occipital lobe epilepsy.
  • Ohtahara syndrome.
  • Parietal lobe epilepsy.
  • Progressive myoclonic epilepsy.
  • Reflex epilepsy.
  • Self-Limited childhood epilepsy with centrotemporal spikes (benign rolandic epilepsy).
  • Self-Limited childhood epilepsy with autonomic seizures (panayiotopoulos syndrome).
  • Temporal lobe epilepsy.
  • West syndrome.

Diagnosis and testing

Treatments and surgery options

Project IMPACTT

Project IMPACTT

Project IMPACTT is a series of webinars intended to educate parents of children with epilepsy about the different challenges they may face. We have assembled a team of doctors, psychologists, nurses, social workers, and parents of patients with epilepsy to help you.

Our goal is to improve care coordination, increase social support, provide education, and increase engagement for teens with epilepsy and their families. This project is supported by the Health Resources Services Administration of the US Department of Health and Human Services.

After watching, please take a minute to fill out a quick four question survey to help us understand your needs better.

Take the Survey

Our Doctors

Our Doctors

Appointments

Appointments

To make an appointment for an evaluation with a Cleveland Clinic epileptologist in Ohio, please call 216.636.5860 or 866.588.2264.

Locations

Virtual Visits

Whether you're a new or existing patient, you can get an initial evaluation or follow-up care from an epilepsy center specialist using your phone, tablet or computer. This means there's no travel or parking, less waiting and significant time savings. Call 216.636.5860 to schedule a virtual visit for you or a loved one and get details on cost and set-up instructions.

MyChart

MyChart connects you to your health care team from the comfort and safety of home. With this secure, online tool you can manage your appointments and complete pre-visit tasks, communicate with your providers, and keep track of your test results and medications.

Medical Professionals

Medical Professionals

Refer a Patient

The Epilepsy Center offers direct referral lines to ease the process of making a patient referral.

To refer a patient to the Neurological Institute via phone, please call our dedicated physician referral hotline at 216.445.8455. An intake coordinator will handle your call directly. If you are unable to reach an intake coordinator, please leave a message and they will return your call within the work day (if left before 1 p.m. ET) or the next work day (if left after 1 p.m. ET).

To refer a patient to the Neurological Institute via fax, please download and complete our physician referral form and fax to 216.636.2596.

DrConnect

Stay connected to patients you refer to Cleveland Clinic through online updates and electronic medical records.

Resources

Resources

Pediatric Epilepsy Support

Our Pediatric Epilepsy Support Group was established in fall 2003 and it provides an opportunity for families to interact with the members of the support group, as well as with each other. The mission of the support group is to meet and address the needs of families who are caring for children afflicted with difficult-to-control epilepsy and to help pediatric patients and families through difficult times. Meeting efforts include:

  • Meet once a week at Cleveland Clinic Children’s.
  • Provide accommodations for parents of hospitalized children by providing an opportunity for comfort through various evaluations procedures or epilepsy surgery.
  • Host a collaborative team approach with volunteer ambassadors and members of the medical and neurosurgical staff.

For more information, contact:

Deepak Lachhwani, MD
Director, Pediatric Epilepsy Support Group
216.445.9818

Sturge Weber Syndrome Program

Sturge Weber Syndrome (SWS) is a rare, nongenetic condition resulting from abnormal development of blood vessels of the skin, eyes and brain. Symptoms may include port wine stains, flat, purple-to-red birthmarks usually affecting one side of the face; glaucoma due to increased pressure within the eye; seizures; stroke-like events; migraine headaches; and focal neurological impairments. The condition poses a number of specific health risks due to its progressive, multi-organ involvement.

Cleveland Clinic's Sturge Weber Program offers:

  • A world-class reputation for diagnosing and treating SWS and related conditions, including one of the largest programs in the world for pediatric and adult epilepsy evaluation, epilepsy surgery and other treatment options.
  • A focus on families, with specialists who address the needs of adult and pediatric patients of all ages.
  • Focused and well-coordinated care to help patients access multiple services through one channel without undue delays.

For more information or to schedule an appointment, call 216.445.0601.

For Referring Physicians

If you have a specific question regarding a patient or our SWS program, contact us at 216.444.8827 or toll free at 1.800.223.2273, ext. 48827.

Tuberous Sclerosis Program (TSC)

Tuberous Sclerosis is a genetic disorder which may be characterized by epilepsy, autism or developmental delay, and skin birthmarks in early childhood. Other organs like the heart and lungs may be involved during early or late life, presenting as heart failure, conduction abnormalities, palpitations and breathlessness.

Cleveland Clinic's Tuberous Sclerosis Program Offers:

  • A focused team approach from expert physicians who deliver comprehensive, multidisciplinary medical and surgical care. These physicians discuss patient care, as needed, to provide the best treatment option.
  • A world-class reputation for diagnosing and treating TSC-related conditions, including one of the largest programs in the world for epilepsy evaluation, epilepsy surgery and treatment.
  • A focus on families, with specialists who address the needs of adult and pediatric patients.
  • Coordinated care so patients can access multiple services through one channel.

For more information or to schedule an appointment: 216.445.8726 or 800.CCF.CARE X58726.

FAQs from parents of children with epilepsy

Anti-seizure medications

Q: Our child has done well since surgery and our doctor offered to gradually stop medications altogether. Is this risky?
A: The most likely outcome is that your child will have no further seizures. Your doctor will weigh the odds which would favor a successful medication withdrawal and share this information with you.

The following risks are rare, however they should be discussed:

  • Risk #1: Child may have one of the typical pre-operative seizures.

    Plan: Restart medication; majority of children become seizure free again with just restarting medication.

  • Risk #2: Child may have a longer or harder seizure than pre-operative typical seizures.

    Plan: Emergency care and restart medication.

  • Risk #3: Seizures may be difficult to stop again.

    Plan: Your epileptologist will need to guide further management.

Epilepsy and driving

Q: Should parents allow and encourage their teen son or daughter to obtain their driver’s license?
A: Yes, parents should discuss this with the physician as the child is approaching the drivable age in the state that he or she lives.

Q: Are there any restrictions or other concerns that should be raised about driving?
A: While seizure control is critical for teenager's ability to drive, it is not the only factor in evaluation for driving. Other factors include compliance and supervision of anti-seizure medication, maturity issues, laws of each state and continued evaluation by physician to make medication adjustments as needed.

Epilepsy and dating

Q: Should teens tell their dates that they have epilepsy?
A: Yes, it is important to keep an open line of communication, in case the patient has a seizure during the date, and talk about the different epilepsy types and their symptoms.

Q: How should the first conversation (about having epilepsy) be carried?
A: The first discussion should be very informative and it should include the facts of epilepsy. People are able to cope with situations better when they know what to expect, so it is easier to discuss all the epilepsy facts to help increase awareness and de-stigmatize this disorder.

Q: Are there any special concerns for teenage girls with epilepsy?
A: Teenage girls might experience changes in their seizure frequency around the time puberty starts, with some girls actually experiencing more seizures before, during or soon after their period.

Q: Can teens with epilepsy have normal intimate relationships?
A: Of course they can, just making sure their partner is aware about the epilepsy helps build encouragement and support in the relationship.

Epilepsy and alcohol and drug use

Q: Are drugs and alcohol usage dangerous in teens with epilepsy?
A:Yes, it is very dangerous because they might decrease the seizure threshold and increase the number and duration of the seizures.

Q: How do drugs and alcohol interfere with the anti-seizure medication?
A: Drugs and alcohol compete in the liver but the enzymes that metabolize the anti-seizure medication, which can intern increase the number of seizures.

Epilepsy and work and college

Q: Should teens with epilepsy work (part-time jobs)?
A: Teens are encouraged to work and drive whenever it is possible. Career choices, types of employment, compliance, follow up, driving, and drug side effects are some of the important factors one should consider while considering employment opportunities.

Q: Are there any career limitations for teens with epilepsy? What opportunities exist for teenagers who have epilepsy as well as other developmental disabilities?
A: A teen with well controlled epilepsy, who is compliant with treatment is eligible for most jobs. Certain jobs may have specific limitations for some conditions even if the symptoms are under control, and eligible teens should clarify this beforehand.

Epilepsy and depression

Q: How common is depression in teens with epilepsy?
A: Depression is very frequent in teens with epilepsy, around 26%.

Q: What are the symptoms of depression in teens with epilepsy?
A: Symptoms of depression are; decreased sleep, decreased energy, increased guilt, irritability, increased anger, isolation from social activities and hobbies, hopelessness, helplessness, and in the severe cases suicidal ideation. Studies have reported that teenagers are particularly at risk for increased suicidal ideation especially those with epilepsy.

Q: How is depression treated in teens with epilepsy?
A: There are two choice. If the depression is mild to moderate, psychotherapeutic intervention such as Cognitive Behavioral Therapy (CBT) are very effective for the treatment of depression in teens. If the depression is moderate or severe the use of medications such as antidepressants are probably the treatment of choice.

Epilepsy and sleep

Q: Is there any relationship between sleep deprivation and seizures? How much sleep should a teen with epilepsy get?
A: This relationship is commonly observed by families; however, is not universal. Generally, sleep deprivation is one of the triggers among multiple other triggers that set the teenager up for more seizures. A healthy teenager must sleep for at least 8 hours of uninterrupted sleep at night, and for sure, many may require 9-11 hours of sleep.

Find support from organizations dedicated to helping you cope with pediatric epilepsy.