The good news is that with expert care and the right support, children with epilepsy can live full, active lives. Many children with seizures in childhood may even outgrow them over time.
Tufts Medical Center has recently opened a dedicated pediatric epilepsy clinic for children with all forms of epilepsy—whether well-controlled or more challenging to manage. The clinic is led by a board-certified epileptologist with specialized training in pediatric epilepsy and EEG interpretation, ensuring children receive the most expert care possible.
Epilepsy is more common than many people realize, but with the right information and guidance, children can thrive. Arnold J. Sansevere, MD, Chief of Pediatric Neurology at Tufts Medicine, answers some of the most common questions families have and explains why specialized care can make a real difference.
What is pediatric epilepsy, and how does it differ from epilepsy in adults?
Epilepsy is when a person experiences more than one unprovoked seizure. It can affect people of all ages—including babies, toddlers, children and adolescents. While some causes and treatments overlap with adult epilepsy, children often have different types and triggers. In kids, epilepsy can be caused by genetic changes, brain abnormalities or sometimes there’s no clear cause. The developing brain also responds differently to seizures, which makes pediatric epilepsy-specific expertise important.
Why was a pediatric epilepsy clinic needed at Tufts Medical Center?
Epilepsy is one of the most common neurological conditions in children, yet it’s often managed by general neurologists who may not have specialized epilepsy training. This can delay or complicate diagnosis and treatment, especially in complex or treatment-resistant (refractory) cases.
At Tufts Medical Center, we have clinicians with fellowship training in epilepsy and EEG interpretation. Our clinic was created to offer families a centralized, coordinated resource for expert diagnosis, advanced treatment options and attention to coexisting conditions like ADHD, anxiety, learning challenges and depression, which are often overlooked.
This level of care simply isn’t available at all hospitals, especially outside the Boston area.
What are the different types of seizures children can have?
There are many types, including:
- Absence seizures: Brief staring spells, sometimes with fluttering eyelids
- Focal seizures: Affect one side of the brain, may involve eye movement, unusual sensations or altered awareness
- Generalized tonic-clonic seizures: Full-body stiffening and jerking with loss of consciousness
- Myoclonic seizures: Sudden, brief jerks of the whole body or limbs
Some seizures are very obvious, while others can be mistaken for daydreaming or clumsiness.
What are the risk factors or common causes of epilepsy?
Risk factors include:
- Abnormal areas of the brain, like a cortical dysplasia or brain malformation
- Autism spectrum disorder
- Brain injury or trauma
- Developmental delays
- Family history of epilepsy
- Genetic mutations
And some children develop epilepsy with no identifiable cause.
How is epilepsy diagnosed?
Diagnosis is based on observing seizure activity and performing an EEG (electroencephalogram), which is a test that measures brain waves. Imaging studies like MRI may also be used if a structural brain issue is suspected.
What treatments are available?
Medication is usually the first line of treatment. The choice of medication depends on the type of seizure (generalized vs. focal) and the child’s age and health.
Other treatment options include:
• Ketogenic diet—a high-fat, low-carbohydrate diet that helps control seizures in some children
• Medical devices like the vagal nerve stimulator (VNS) are implanted in the body to send electrical signals to the brain
• Surgery for carefully selected cases where seizures don’t respond to other treatments
New medications are continually being developed, particularly for genetic epilepsies, and researchers are actively working on genetic therapies for select conditions.
Can epilepsy be managed without medication?
Some children may benefit from non-drug therapies like dietary management (ketogenic or modified Atkins diet) and implanted devices like the VNS. Lifestyle factors like adequate sleep are also very important because sleep deprivation can increase the risk of seizures.
What’s the typical age of onset?
It varies widely. Some babies are diagnosed shortly after birth, especially in genetic epilepsies, stroke, and if there is loss of oxygen to the brain, while others may develop seizures at any stage of childhood or adolescence. How epilepsy presents often times depends on the cause.
Can children with epilepsy play sports?
Yes, with the right precautions. Physical activity is important for all children. While certain activities may carry some risk, most children with well-managed epilepsy can safely participate in sports and play, especially when supervised and supported.
What are some common misconceptions about epilepsy?
- “My child will always have epilepsy.” Not true. Many children outgrow their seizures, especially if their epilepsy is well-managed from an early age.
- “We’re the only ones dealing with this.” Also false. Epilepsy is much more common than people realize. There are likely several children in a given school living with epilepsy.
- “Surgery is a last resort.” Some families and even doctors hesitate to consider surgical evaluation, but early referral leads to better outcomes. Not all epilepsy surgeries involve removing brain tissue—there are less invasive options available.
- “Epilepsy is just seizures.” In reality, many children also struggle with coexisting conditions like ADHD, anxiety, depression and learning differences. These require just as much attention and support.
What should you do if a child has a seizure?
Seizure first aid is critical:
- 1. Stay calm.
- 2. Turn the child on their side to keep the airway clear.
- 3. Time the seizure. If it lasts more than 5 minutes or it's their first known seizure, call 911.
- 4. Administer rescue medication if prescribed and the seizure lasts longer than usual.
What’s the one message you want families to hear?
Pediatric epilepsy is much more common than people think. Many children live with this condition, and it does not mean they will have poor outcomes. With the right care, including specialists trained in epilepsy, we can not only manage seizures but also address the emotional and developmental needs of each child to support the best possible outcome.
