At the Barrow Neurological Institute at Phoenix Children’s, we believe that early consideration of surgery or other appropriate therapies should be considered for children with intractable epilepsy. Unfortunately, fewer than 1% of these children are evaluated for epilepsy surgery.

While it is natural for families to have reservations about brain surgery for their child, it is important to recognize that epilepsy surgery has significantly improved the quality of life and future of many children. Studies show that epilepsy surgery can greatly reduce the frequency of seizures and, in some cases, may even lead to a seizure-free life.

Living with poorly controlled epilepsy can significantly impact a child’s development, relationships and education. Uncontrolled seizures may lead to disability and increase the risk of SUDEP (sudden unexplained death in epilepsy patients).

How We Can Help

If your child has intractable epilepsy, advanced care may be necessary. Start by asking your child’s primary care doctor for a referral to one of our epilepsy subspecialists.

Our team will conduct a thorough evaluation to determine the most appropriate next steps for your child. Since every child’s situation is unique, consulting with an epileptologist will provide you with a clearer understanding of the available treatment options for your child.  

Possible options may include:

Evaluation: What to Expect

At your first visit, we’ll gather a detailed history and perform a comprehensive physical examination of your child.

Before or during your child’s first visit, we will need information about your child’s original diagnosis, if any medications have been tried and the results of previous tests and examinations. If your child has already seen a neurologist, please provide us with their records, including test reports, images and clinical notes.

Not all children require, or are candidates, for surgery. If your child may be a potential candidate for surgery, our team will conduct a comprehensive evaluation to determine the most appropriate course of action.

The first step in a presurgical evaluation is an admission to our Pediatric Epilepsy Monitoring Unit. During this period, your child will be monitored for several days to capture and observe seizures. We will thoroughly assess the physical characteristics of the seizures and compare these observations with the EEG findings.

Your child may need additional tests, such as:

This test can help us understand the underlying brain networks and target where seizures are coming from.

This test looks at the way the brain metabolizes glucose, or sugar. It can sometimes provide clues about areas that are not functioning well and are potentially a source of seizures.

This test examines blood flow to the brain during a seizure compared to when your child is not having a seizure. By comparing these differences in activity, we can gain insights into the potential source of the seizures.

This test measures magnetic currents in the brain to detect epileptic or epileptiform features, such as spikes or sharp waves. MEG provides additional information that complements the findings from the scalp EEG.

This test assesses different domains of your child’s intelligence and can help identify areas of the brain that are functioning abnormally. This information is valuable in detecting dysfunction within the brain’s networks and understanding how epilepsy may be affecting cognitive function.

When Further Testing is Needed

Based on your child’s specific situation, their epileptologist may recommend one or more of these tests. After these evaluations, some children may proceed directly to surgery, while others may require further assessment with additional specialized EEG monitoring, including stereo EEG (SEEG) or subdural EEG grid placement.

SEEG is used to identify where seizures start. Surgeons insert electrodes into the brain through small holes drilled in the skull. The electrodes are positioned with a robotic device. After the procedure, your child will be transferred to the Epilepsy Monitoring Unit where the epilepsy team will monitor brain activity for seizures.

Subdural grid placement is another method of mapping the location of seizures. This method is used when an area over one side of the brain, near the surface, is suspected to be the cause of seizures. For this, the surgeon removes part of the skull, a procedure called a craniotomy. They place electrodes directly on top of the brain surface. Following placement, your child will go to the Epilepsy Monitoring Unit so that the epilepsy team can determine where seizures are starting.