At Connecticut Children’s Epilepsy Center, our highly skilled neurologists care for children who experience seizures caused by a diverse set of neurological disorders. Using a variety of assessment measures, we are able to diagnose the cause of seizures and develop an appropriate treatment plan. Our Epilepsy Center meets criteria to be a Level 3 Epilepsy Center by the National Association of Epilepsy Centers.
Not all seizures are epileptic. They can also be caused by high fever, brain tumors, head injuries, exposure to poisons, brain infections, and genetic abnormalities. Epileptic seizures can occur in many different manners, ranging from unobservable symptoms to displays of severe physical disruption depending on whether the seizure is partial or generalized. EEG monitoring and MRI are two tests that our neurologists use to determine where a child’s seizures originate. We also offer EMG, evoked potentials, lumbar puncture, and muscle biopsy and histology.
- In our state-of-the-art Epilepsy Monitoring Unit (EMU), we evaluate seizures with prolonged EEG monitoring. Observing seizures on video while recording EEG allows our epilepsy specialists to determine what type of seizures or epilepsy the patient has, and to see if we can find where the seizures start in the brain. These tests often lead to brain surgery, which in some cases can cure the epilepsy.
- Inside the EEG lab, which is part of Connecticut Children’s Neurodiagnostics Center, specially trained technologists use sophisticated equipment to record the brain’s electrical activity. Small electrodes placed on your child’s scalp and forehead measure the electrical impulses of the brain and transmit the information to a computer. These tests, which are painless and can be performed on children of all ages, are used to detect seizure activity and distinguish epileptic seizures from other seizures and spells. Sometimes EEG telemetry is coupled with video monitoring over a longer period of time so neurologists can observe seizures and other behaviors that correlate with brain activity (prolonged EEG monitoring). Your child may be asked to follow special instructions during the test, such as to open and close the eyes, focus on an object or listen to clicking sounds through headphones. These known stimuli are introduced to help diagnose seizures.
- An MRI is a painless procedure that produces multidimensional views of the brain. These images allow neurologists to detect scar tissue in the brain, and in some cases MRI can identify the part of the brain where seizures begin.
There are many effective treatments that help children who have epilepsy lead normal lives with seizures that are well-controlled. The condition can often be managed with medicine. Our neurologists have expert knowledge on the wide selection of medications available for treating different manifestations of epilepsy, and offer opportunities for patients to participate in clinical trials of the latest medication therapies.
Some children who are resistant to medicine or cannot tolerate its side effects can benefit from surgery to treat epilepsy. Neurosurgery to remove tumors or the known epileptic focus—the area of the brain where seizures begin—can dramatically reduce the number of seizures a child has or stop seizures entirely. We are also engaged in research to help explore new treatments for epilepsy, such as cannabidiol.
Ketogenic Diet Program
Changes in diet have been proven to reduce epileptic seizures in children. Our neurologists work closely with dietitians to evaluate patients who are candidates for the Ketogenic Diet Program and to educate and monitor patients and families who initiate this treatment.
The ketogenic diet is a medical nutritional therapy that has a proven affect on reducing epileptic seizures in children. This method of treatment requires pediatric patients to follow a carefully calculated diet that is high in fat, low in protein and virtually free of carbohydrates. The diet eliminates foods such as bread, cereal, pasta, potatoes, rice, sweets, and milk.
The diet is initiated under close medical supervision in the hospital over a three to four day stay. During this time, blood sugars and urine ketone levels are monitored and Connecticut Children’s neurologists, dietitians and advanced trained nurses teach families about appropriate food selection, nutrition calculation, vitamin and mineral supplementation, and over-the-counter products. This care team stays in close contact with patients and families as they adjust and adhere to the ketogenic diet. Children return to the medical center every one to three months for growth assessments and follow-up seizure evaluation.
Neonatal neurology is a specialized field within the specialty of neurology. The developing brain can be particularly susceptible to various injuries and inborn errors, with specialized treatments as well as diagnostic modalities required. Connecticut Children’s neurologists works closely with neonatologists to identify those children at risk for neurological problems, and to ensure accurate diagnosis and appropriate treatments.
Our division provides prolonged EEG monitoring with neurologists trained in the interpretation of neonatal EEG and treatment of neonatal seizures. We also have specialists in neuromuscular disorders and genetic disorders, who can provide specialized consultation to fit the needs of the child and their family.
Our collaborative team approach has the goal of helping each child reach their full potential.
Neonatal Epilepsy Program
Seizures in neonates differ significantly from older patients. Generalized tonic-clonic seizures are rare in neonates. These are most commonly seen in the NICU. The most common cause of neonatal seizures is hypoxia. Other causes include bleeding, stroke, infections, metabolic disorders and channelopathy. We provide comprehensive testing of neonatal seizures such as EEG monitoring. We work with Connecticut Children’s neonatology program to treat babies with seizures.
Jennifer Madan Cohen, MD
Medical Director – Epilepsy Center, Neurodiagnostics Lab and Ketogenic Diet Center
Mark Schomer, MD
Alexis Rivera, ASM, BGS, MBA, R.EEG.T
Manager, Sleep and Neurodiagnostic and Epilepsy Center
Jeffrey Agli, APRN
Lori Schick-Schneider, RN
Epilepsy Nurse Coordinator
Beth Chatfield, RD
Ketogenic Diet Coordinator