Treatments for refractory epilepsy
Treatment options:
The Alberta Children’s Epilepsy Program has one of the largest Ketogenic Diet programs in Canada. We usually consider patients for this program who either suffer from refractory seizures or have specific metabolic etiologies for their epilepsy, that are known to respond well to ketogenic diet.
It is important that families are aware that ketogenic diet is a long-term commitment that requires a lot of commitment, training and persistence from the families.
Families are therefore encourage to take an information and training module prior to meeting a dietician to start the diet.
Treatment with cannabidiol has gained a significant interest in families with epilepsy. Treating children with cannabidiol can be challenging in our health system as cost are not covered by health insurance. Many different sometimes unregulated cannabis products are available on the Canadian market.
Our physicians all have experience with CBD and will answer CBD specific question from our patients with epilepsy. We are supporting the prescription of medical CBD in patients with refractory epilepsy, after a detailed discussion of individual risk and benefits with the families.
It has long been known that some epilepsies are caused by auto-immune diseases such as antibody mediated encephalitis. In our program we work together with experts from neuro-critical care, rheumatology and pediatrics to treat affected patients with the necessary immunomodulatory treatments.
Over recent years we have also learned that some refractory epilepsies can cause inflammation and immunomodulatory treatments can improve the seizure situation in rare cases. Our program therefore also offers immunomodulatory treatments to select patients with epilepsies that do not respond to multiple anti-seizure medications.
Brain stimulation is a possible treatment for patients with refractory epilepsy that have failed to respond to anti-seizure medications and are not candidates for epilepsy surgery.
The only stimulation method that is currently available in Canada for children is the Vagus Nerve Stimulator. This is a stimulation that is implanted at the Vagus Nerve at the side of the neck and is proven to reduce seizure frequency. In collaboration with the neurosurgical team, we have the option to implant VNS in our program.
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