Neuromodulation Program

During a complete evaluation, we monitor the electrical activity in your child’s brain and do brain imaging studies and neuropsychological testing. These tests help us find out more about your child’s seizures or movement disorder and the effect on your child.

While your child stays in our special monitoring unit for up to 1 week, we:

• Use EEG (electroencephalography) equipment, a painless way to record electrical activity in your child’s brain.
• Make video and sound recordings of your child to see and hear what happens when they have a seizure or muscle spasm.
• Use brain imaging techniques such as MRI scans, PET scans and SPECT. These images, along with neuropsychological testing, help us see patterns of behavior and movement and find the area of your child’s brain where harmful electrical activity starts.

This full assessment helps us recommend the best neuromodulation options for your child.

To learn more, see Tests to See If Epilepsy Surgery Is Right for Your Child (PDF) (Spanish) (Somali) (Vietnamese)

VNS helps prevent seizures by sending a small, on-and-off electrical pulse to the vagus nerve. The vagus nerve starts in the brainstem (just below the brain) and goes down the neck and into the chest. Some people think of VNS like a pacemaker for the brain.

During surgery, the neurosurgeon puts the stimulator under the skin on the left side of your child’s chest. The device is about the size of a bottle cap. After the area heals, your child’s provider sets the device using a wand connected to a computer.

Most often, the device works on its own to stop seizures. But if your child senses the start of a breakthrough seizure, you or your child can place a small, handheld magnet over the spot where the device is located. This provides on-demand stimulation to stop the seizure.

The U.S. Food and Drug Administration (FDA) has approved VNS for children at least 4 years old. We have placed over 70 VNS devices in children and care for well over 200 patients with these devices.

• Read more about Vagus Nerve Stimulator (VNS): A Treatment for Drug-Resistant Epilepsy (PDF) (Pashto) (Spanish) (Somali) (Vietnamese)

In DBS, a small battery-powered device, like a pacemaker, sends low-level electrical signals to specific areas in your child’s brain. The device helps control seizures and muscle spasms to improve your child’s quality of life.

Seattle Children’s is the only provider in the Northwest to offer DBS for children.

We also have used DBS to reduce symptoms in children with rare genetic disorders such as Lesch-Nyhan, which causes some children to harm themselves.

During surgery, the neurosurgeon places the device under the skin in your child’s chest and puts 2 thin electrical wires into the deep brain tissue where seizures start.

A few weeks after surgery, your child’s neurologist programs the device to determine how often and how much to stimulate your child’s brain. It will take several clinic visits to decide the right settings needed to control your child’s seizures or muscle spasms while minimizing side effects.

The neurologist can adjust the device as needed by using a remote control. Adjustment does not require surgery.

We will give you a device like a smartphone to adjust stimulation and track symptoms at home.

DBS can work on its own or be combined with VNS to reduce seizures and treat movement disorders.

Read more:

• A New Neurosurgical Procedure Is Bringing Promising Seizure Relief to Some Epilepsy Patients
• Deep Brain Stimulation (DBS): A Treatment for Drug-Resistant Epilepsy (PDF) (Spanish) (Somali) (Vietnamese)

In RNS, a battery-powered device monitors your child’s brain waves and sends a signal when it senses that a seizure may be starting. The signal stops the seizure. A neurosurgeon places the device in your child’s skull and connects thin wires from the device to 1 or 2 parts of the brain where your child’s seizures start.

A doctor who specializes in epilepsy (epileptologist) will program the device during a follow-up clinic visit.

We will give you a small wand and computer tablet. Use the wand to download information from the RNS device to the tablet each day. Once a week, upload the data on the tablet to an online database. This database gives your child’s epilepsy doctor vital information about how often your child has seizures and their brain wave activity.

Read more:

• Innovative Epilepsy Procedure Offers New Avenue of Treatment to Reduce Seizures for a child whose seizures continued after trying medicine, diet and other surgeries.
• Responsive Neurostimulation System (RNS): A Treatment for Drug-Resistant Epilepsy (PDF) (Spanish) (Somali) (Vietnamese)