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Epilepsy is a common condition that causes people to have unpredictable and recurrent seizures.
There are many types of epilepsy. Many types of epilepsy begin in childhood.
Some people can experience a seizure and not have epilepsy. For example, 3 per cent of young children have febrile seizures. A single seizure does not mean that your child has epilepsy.
Anti-epileptic medication controls seizures for most people. For some people, medication does not allow full seizure control.
The Children's Epilepsy Program is part of Austin Health's Comprehensive Epilepsy Program, which is the leading epilepsy centre in Australia.
We offer a range of tests that can help to diagnose your child's particular type of epilepsy. Some of these tests require an admission to the Paediatric ward. These tests can play an important role in determining which treatments your child may benefit from.
We are one of a small number of centres that offer epilepsy video monitoring and surgery.
We provide the following services:
We run the following clinic:
An electroencephalogram (EEG) is a very useful test in determining whether a person is having seizures or not, and if so, what kind of seizures. An EEG measures the brain's electrical rhythms.
Before the test begins, your child is fitted with an electrode-covered cap, which will transmit the brain's rhythms to the recording equipment. Muscle tension can interfere with the test, so it's important to relax - the child is able to lie on a bed during the test.
The EEG technicians may ask your child to open or close their eyes and may turn on flashing lights to monitor the different brain rhythms. For small children, it's often useful to book the EEG around the time they usually take a nap.
Video EEG monitoring involves the same test as a routine EEG, but your child wears the electrodes for a much longer period of time. The electrodes are glued to the head and the head is bandaged. Your child stays on our Paediatric Ward for the length of the test. He or she is video recorded for 24 hours a day (apart from in the bathroom) during the monitoring.
During the admission, your child has to stay in bed or in range of the camera all the time, except to go to the bathroom. This way, any seizures that occur will be captured on video and recorded on the EEG. This kind of monitoring is only useful if your child has frequent seizures, typically occurring at least every 1-2 weeks. Medication may be reduced upon admission to increase the likelihood of episodes or seizures.
An MRI scan uses magnetic fields to scan your child's brain. The scan allows doctors to see the structure of their brain, and to see if there are any abnormalities in this structure. Your child must remove any jewellery before the scan. The scan takes about 35 minutes. The machine is quite noisy, so children can wear headsets and listen to music during the procedure. The MRI scan is not dangerous or painful. In some young children, sedation or a general anaesthetic may be required so they do not move around.
Twenty minutes or so before a PET scan, a low-dose radioactive substance (tracer) called a radioisotope is given to your child by injection. This substance allows doctors to see how the brain metabolises glucose. The region of the brain in which the seizures start often has reduced metabolism in between seizures, and increased metabolism during a seizure.
The test takes about 35 minutes of lying still, and in some young children sedation may be required so they do not move around. Every care is taken to ensure that the injection does not distress your child.
A SPECT scan looks at the picture of blood flow to the brain during a specific 30-second time window. We have shown that an ictal SPECT scan early in a seizure is very helpful in localising where a seizure begins in the brain.
It is very important to have a parent observing their child to indicate as soon as a seizure begins and call the attention of the nursing staff. The nursing staff will then race into the room and draw up the appropriate dose of radioactive substance out of the radioactive safe in the video monitoring room. They will then inject this into the intravenous line of the child. The radioactive substance then localises in the brain within 30 seconds giving a picture of the blood flow at that moment. Thus, the earlier this can be given following seizure onset, the more reliable and helpful the picture is in terms of determining seizure origin. The scan can then be taken at any time over the next two hours and will show the picture of the blood flow to the brain at the time of the radioisotope injection.
Many children will be able to lie still for this scan, however, some children may require sedation to lie still. Interpretation of the ictal SPECT scan is more reliable with an interictal (between seizures) scan. Sometimes this is only performed after the ictal scan can be obtained as one does not always successfully obtain an ictal scan. Some patients may require more than one ictal SPECT scan if there is a suggestion that there are multiple types of focal seizures coming from different areas of the brain.
If your child is admitted to Children's Epilepsy Program, they will be assessed by one of our neuropsychologists. This helps to determine whether there are subtle difficulties with learning or memory that reflect which part of the brain your child's seizures are coming from. This also helps inform whether possible epilepsy surgery will affect language, memory or learning. The neuropsychologists also have an important role in testing the child post-operatively to look for changes.
You need a referral from your GP, specialist or health care provider to access this service.
Your child will be referred to see an epilepsy neurologist.
If the epilepsy neurologists think that an admission would be beneficial, and you are happy for this to take place, your child is then booked in to the paediatric ward.
The epilepsy liaison nurse will discuss with your family the best time for the admission to take place, and organise the admission. She/he may also be able to assist with accommodation if the family is coming from interstate, country Victoria or overseas.
Find out how to refer your patient.
Jenny Spiller
Nurse Unit Manager
Phone: 03 9496 5516
Fax: 03 9496 5386
Email: jenny.spiller@austin.org.au
Brialie Forster
Developmental Epileptic Encephalopaties (DEEs) Clinical Nurse Consultant
Phone: 03 9035 7190
Email: brialie.forster@austin.org.au
Phone: 03 9496 5943
Karen Stewart
Email: karen.stewart@austin.org.au
Laura Shanahan
Email: laura.shanahan@austin.org.au
Emily Francis
Email: emily.francis@austin.org.au
Rachel Wilkinson
Email: rachel.wilknson@austin.org.au
Open hours: Monday to Friday 7.30am to 4pm
Professor Ingrid Scheffer
Director, Paediatrics
Ward 2 West
Level 2, Austin Tower
145 Studley Road
Heidelberg VIC
Department of Paediatrics
Austin Hospital
PO Box 5555
Heidelberg VIC 3084
Australia
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