Epilepsy Treatment In India

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What is Pediatric Epilepsy?

Epilepsy is a brain disorder where a person has recurring seizures and it is one of the most common disorders of the nervous system. The brain consists of nerve cells which communicate with each other through electrical activity. The seizures are triggered by changes in the electrical and chemical activity in the brain that interrupts normal brain signals. Anything interrupting the normal connections between nerve cells in the brain will cause a seizure and this includes a high fever, high or low blood sugar, head injuries, alcohol or drug withdrawal, or brain development problems prior to birth. Often a cause for the seizures and epilepsy cannot be found but when a child has 2 or more seizures with no known cause, this is diagnosed as epilepsy.

Epilepsy is a disorder of repeated seizures and unprovoked seizures more common in young children than in adults. There are many different types of epilepsy which have different causes, extents, and effects. Generally, there are two major types: generalized epilepsy, in which seizures affect the entire brain, and partial (or focal) epilepsy, where seizures begin in a specific portion of the brain. Epilepsy will increase a child’s chances of having mood disorder or learning disorder. 

What are Pediatric Seizures?

A pediatric seizure could be an alarming event, and a suspected seizure should be investigated by a medical team. There are many causes of paediatric seizures besides epilepsy which includes fever, meningitis, a metabolic imbalance, exposure to a toxin, head injury, or a tumor or other lesion. Sometimes no cause is ever determined. 

There are different types of seizures. Some seizures last only for a few seconds, while others can last a few minutes. The type of seizure will depend on which part of the brain, and how much of the brain is affected, and what happens during the seizure. The two categories of epileptic seizures are focal (partial) seizure and generalized seizure.

What Causes Epilepsy?

A seizure happens when cells in the brain “talk” too much and disrupt the brain’s normal electrical signals temporarily. Epilepsy and seizures have many possible causes, including:

  • head injuries
  • birth trauma
  • brain development disorders
  • brain tumors
  • heredity
  • degenerative brain disorders
  • stroke
  • metabolic problems

In more than half of the children, a cause cannot be found.

What are the Symptoms for a Seizure in a child?

Your child’s symptoms will depend on the type of seizure. General symptoms or warning signs of a seizure may include the following: 

  • Staring
  • Jerking movements of the arms and legs
  • Stiffening of the body
  • Loss of consciousness
  • Breathing problems or stopping breathing
  • Loss of bowel or bladder control
  • Falling suddenly for no reason, especially when associated with loss of consciousness
  • Not responding to sound or words for brief periods
  • Appearing confused or in a haze
  • Nodding head rhythmically, when associated with loss of consciousness
  • Periods of rapid eye blinking and staring

During the seizure, your child’s lips may be tainted blue, and his or her breathing will not be normal. After the seizure, your child will be sleepy or confused.

How is Epilepsy Diagnosed?

Making a diagnosis will involve identifying a condition or disease based on signs and symptoms. An epilepsy diagnosis is made when seizures occur more than once without any reason, such as fever or injury. Any child without a known diagnosis of epilepsy who experiences an unprovoked seizure will need immediate medical attention and then they have to follow-up with the primary care pediatrician soon thereafter. If seizures reoccur, then the children must consult a pediatric neurologist, who is specialized to manage seizures and epilepsy. While every child’s diagnostic process will vary, the major step in the process includes the following:

  • Detailed medical history: It will include questions regarding the mother’s pregnancy and delivery, any family history of epilepsy, and if the child had a high fever, serious head injury or breath-holding.
  • Detailed account of the seizure: The person present during the time of the child’s seizure, should narrate the specific details to the physician.
  • Physical examination: cardiac examination, neurological examination, and mental health status is examined.
  • Blood test: To identify potential causes or other significant illnesses.
  • Computerized Axial Tomography (CAT) or CT Scan: It is used to determine whether a seizure was caused by an acute neurological lesion or illness.
  • Electroencephalogram (EEG): It can be used to assess the risk of seizure recurrence and may help to determine the seizure type and epilepsy syndrome.
  • Magnetic Resonance Image (MRI): It is a picture of the brain which will be used to evaluate children with seizures that may have started in a particular part of the brain.

After the examination, tests, and observation period, a physician can determine whether a child has epilepsy.

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How is Epilepsy Treated?

Treating epilepsy is challenging because each child responds differently to various types of treatment. Some may respond to medication; others find seizure relief through a ketogenic diet; and others will need surgery to achieve seizure freedom. Our specialists will help your family understand the treatment options and what might work best for your child. However, epilepsy Treatment usually begins with medication and it is important to remember that epilepsy is a complex condition and every child is different. Every child will respond to treatment in a different way. If medication does not work, other options include:

  • Surgery – The goal of surgery is to maximize your child’s quality of life and minimize the impact of seizures on your child’s and family’s lives and, when possible, eliminate them altogether. This means reducing medication side effects, addressing emotional concerns, and helping families better understand their child’s condition. 
  • Dietary therapies such as Ketogenic and Modified Atkins Diet – Specialized diets can help some children achieve seizure control when anti-seizure medications are not effective.
  • Medical devices to prevent and control seizures.

What are the Treatment Options for Pediatric Epilepsy?

  • Medication – Our team includes a clinical pharmacist who is experienced in treating children with epilepsy.
  • Ketogenic and Modified Atkins Diet – Specialized diets can help some children achieve seizure control when anti-seizure medications are not effective.
  • Surgery – The goal of surgery is to maximize your child’s quality of life and minimize the impact of seizures on your child’s and family’s lives and, when possible, eliminate them altogether. This means reducing medication side effects, addressing emotional concerns, and helping families better understand their child’s condition. 
  • Psychological Support – Our clinical psychologists provide assessments, brief treatments, family education and, if needed, referrals for outpatient psychological care.

What is Pediatric Epilepsy Surgery?

The goal of every pediatric epilepsy surgery will be to stop all seizures. Many children with epilepsy can become seizure-free with medication, but for children who don’t respond to medication, surgery may be a better option. 

When seizures don’t respond to medication or other treatments, your child’s physician will recommend for surgery. Surgical evaluations are done in the hospital within five to seven days. During this time, physicians will study your child’s seizures to learn exactly what part of the brain seizures are coming from. If surgery is an option for your child, the care team will recommend what type of surgery is required. 

Surgical epilepsy treatments include:

  • Resection- During a resection, a section of brain tissue is removed which was causing the seizures. 
  • Vagal nerve stimulation- The vagus nerve carries signals that affect the central nervous system and reflex responses. Vagal nerve stimulation controls seizures by sending a stream of low electrical impulses through the vagus nerve; this prevents surges that cause seizures.
  • Disconnection- A disconnection procedure disrupts the nerve patterns responsible for your child’s seizures. A disconnection is best if the tissue responsible for the seizures is in such an area, which we cannot remove safely. 

Epilepsy Treatment In India:

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