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The Epilepsy Center at Children’s Health is a Level 4 Epilepsy Center, providing the highest level of treatment for children with epilepsy. That means we have experience identifying neuronal migration defects, and in treating the condition.
Neuronal migration defects are structural disorders that happen to the brain as a fetus develops. Those areas of the brain that are affected lack the appropriate neural connections to function properly, which can result in epilepsy and seizures.
We were the first such program in the country to be certified by the Joint Commission, the nation’s preeminent standard-setting accrediting and certifying regulatory body in healthcare. Our interdisciplinary medical team has the experience to not only comprehensively diagnose children with this condition, but we remain the area’s only center to perform the most advanced procedures and therapies for the treatment of epilepsy.
Because this condition affects your child and your family, you will be glad to know we provide care for the whole family, including education and support.
In addition, the Epilepsy Center works with referring doctors and area Emergency Departments to:
The signs and symptoms of a neuronal migration disorder vary depending on the area of the brain affected. At birth, there may be little sign that a child has a neuronal migration disorder – symptoms tend to become more obvious as the child does not grow and develop as expected.
Seizures are a symptom of the disorder. The most common seizures include:
This type of seizure can involve shaking (called convulsions) combined with the body getting rigid, clenching the jaw, and biting the tongue. Some people still know this type of seizure as a grand mal seizure.
This type of seizure may involve staring into space. Or your child may stop talking abruptly and then start talking again, or start repetitious movements like chewing their lips or moving a hand. These types used to be known as petit mal seizures.
To diagnose neuronal migration defects that cause epilepsy, your doctor will do a detailed physical exam of your child, which may include an electroencephalogram (EEG). The EEG helps determine where in the brain the spasms are coming from and if your child has epilepsy. An EEG is performed by placing electrodes on the scalp and recording the electrical activity of the brain.
Neuronal migration defects may be a genetic condition or result in environmental factors.
Once tests are complete, your doctor will prescribe treatment. It is important to begin the right treatment, as quickly as possible. Untreated epilepsy can increase your child’s risk of serious injury from seizures. Seizures can also put your child at social and academic disadvantage.
Treatments can include:
Anti-epileptic drugs work to control seizures. While these medications cause side effects (e.g., drowsiness, fatigue, rashes), they help someone with epilepsy lead a normal life. Seizures caused by neuronal migration defects can be difficult to control with medication.
If seizures happen so often that they reduce a child’s quality of life, surgery may be necessary. Surgery can implant a small device in the brain to regulate electronic brain activity and reduce seizures. This device is called a vagus nerve stimulator, and is generally approved for patients older than 12 years of age. Surgery may also be performed to remove the section of brain where seizures originate. The Epilepsy Center at Children’s Health’s epilepsy surgery program has a high rate of success, with our patient outcomes often exceeding those of other centers.
Your physician may prescribe a ketogenic diet for your child, which includes high-fat, low-carbohydrate foods.
Neuronal migration defects cause structural disorder of the brain, which, in turn, can result in seizures.
The epilepsy symptoms most people recognize are shaking (called convulsions) combined with the body getting rigid, clenching the jaw, and biting the tongue. These are called tonic-clonic seizures and many people still know them as grand mal seizures. But some seizures are barely noticeable. Children may stare into space, stop talking abruptly and then start talking again, or start repetitious movements like chewing their lips or moving a hand. These types of seizures are called absence seizures, which used to be known as petit mal seizures. Sometimes a child may experience smelling something that isn’t there, numbness or a tingling sensation before the seizure. These are called auras.
If the seizure is small twitching or staring, they should come out of it easily. For convulsions, make sure your child is in a chair that they can’t fall out of or lying on the floor with a pillow under their head. Turn their head to the side, but NEVER try to put anything into their mouth. Do not shake or hit them or shout at them. If the seizure lasts for more than five minutes or seems violent, call 9-1-1.
After a seizure, your child may be confused, foggy or tired. If they want to lie down, let them.
To diagnose neuronal migration defects, your doctor will do a detailed physical exam of your child, as well as an EEG and a tissue sample.
There is no treatment for neuronal migration defect, but treatment is focused on the symptoms, which can include seizure. While the seizures associated with this condition are difficult to control with medication, special diet and surgery can help control them.
Our Epilepsy Center will provide you with resources to help both you and your child. The Resources link on this webpage is also a good source for more information about epilepsy and support groups.