Early Intervention Is Key to Pediatric Epilepsy starts waging war early—physicians should, too

“Extensive studies have We now know that timing is critical in treating refractory epilepsy shown that continued patients—especially children. Physicians have generally waited until multiple medications have failed while trying to manage parents impact cognition, uncomfortable with an epilepsy diagnosis or further treatment. language, attention However, the effects of continued seizures on a young brain—even and memory by limiting for a few months—can be significant and damaging. neuron survival, while The Pediatric Epilepsy Program at Sutter Health increasing risk of anxiety Sacramento, an NAEC-accredited level 4 center, uses and depression,” says a triage system to ensure referrals are seen Michael Chez, M.D., FAAN, within hours or days—not months. FAES, Director of Pediatric Instead of being referred after years of damage, patients are treated Epilepsy and Research earlier and may return to the referring physician’s care with a at the Sutter Health comprehensive plan for seizure management—and in many cases Neuroscience Institute. will remain seizure-free. “Every infant or child with the diagnosis should have a experience sudden consultation with a pediatric 1 in 1000 unexpected death early on.” in epilepsy (SUDEP)1 patients Starting Out Right—Specialized Pediatric Epilepsy Clinics

It’s easy to underestimate the scope of complexity and resources required to manage refractory , from development to unique family stresses. A full-service pediatric epilepsy clinic model offers a comprehensive level of care that goes beyond the resources or expertise of pediatric neurology or pediatric hospitals.

More Accurate, 24/7 Testing Even more so than young or middle-aged adults, children and adolescents can experience more types of epilepsy—acquired and genetic—from different causes and with a wide range of complex symptoms and risks. Timely and appropriate diagnosis is critical for the child and the family.

“Our clinic’s state-of-the-art neuroimaging techniques, such as high density EEG and MRI protocols, as well as our leadership in genetic epilepsy, ensure exceptionally Surgery vs Medication precise assessment,” says Dr. Chez. “There are syndromic eliminated eliminated and genetic conditions like Lennox-Gastaut seizures in seizures in only that can have lifelong effects if not identified early or managed appropriately.” 58% 8% Sutter Medical Center, Sacramento provides an enhanced level of testing with 24/7 EEG technical support. A “Full Shop” for Easier Transitions “At non-epilepsy centers, often there’s no one to do an When most patients reach age 18, their pediatric care EEG in the middle of the night,” explains Dr. Chez. “SMCS teams stop providing service. Finding a new program, has the 24/7 tech support essential for emergent cases.” possibly in a new city, can be disruptive and inconvenient. At Sutter Medical Center, care can continue with our adult Unmatched Research and Treatment epilepsy specialists. Research-guided advances in medication, neuroimaging and surgical techniques—many of them pioneered in “One quality that distinguishes our specialized clinic is the Sutter Health network—have made some surgical the integrated relationships between adult treatments more effective than medication. In fact, in and other specialists and support workers in our network,” randomized control trials, surgery eliminated seizures says Dr. Chez. “The result is easier, more gradual in 58 percent of uncontrolled epilepsy cases, while transitions from neonatal through adulthood.” medication did so in only eight percent.2

SUTTER MEDICAL CENTER, SACRAMENTO OFFERS:

Minimally The latest Integrated Ongoing clinical Social worker Pharmacological invasive surgery medications, nutrition services; research (autism, support management (laser ablation, including CBD ketogenic diet stem cells, neuromodulation) pharmaceuticals)

2 | Early intervention is key to pediatric epilepsy Hands-On, Board-Certified Epileptologists Manageable Location A family’s direct access to a board-certified When it comes to medical travel with kids, location epileptologist is essential for successful early matters. Sutter Medical Center, Sacramento, offers intervention and management. excellent pediatric epilepsy care with the added benefit of easily accessible services and amenities found in a mid- “The doctor’s expertise makes a big difference with size city. For example, numerous parks and many family- a serious, complex condition like pediatric epilepsy, friendly activities are readily available when patients aren’t where there are many potential drug interactions and receiving care. development issues,” says Dr. Chez.

In many epilepsy centers, care decisions might be EXPERIENCE MATTERS handled by a non-epileptologist. And often, staff do not have the fellowship training required beyond pediatrics “We have deep roots in epilepsy care—around 30 years or neurology. At Sutter Medical Center, Sacramento, of experience and robust research studies that guide the clinic orientation means a direct, one-on-one our care,” says Dr. Chez. “From helping participate in relationship between doctor, child and family—and advocacy groups like Citizens United for Research in every doctor on staff is board certified in both pediatric Epilepsy the Epilepsy Foundation and Lennox Gastaut epilepsy and child neurology. These epileptologists are Foundation, to offering the absolute latest treatments supported by nurse practitioners, nurses, social worker and support, the passion and expertise are here to and neuropsychologists for full team patient support. facilitate successful early intervention.”

1Thurman, DJ. Epilepsia, 2014

2Wiebe, Samuel, et al. N Engl J Med 2001; 345: 311-318

About Sutter Health Network Services The Sutter Health network offers level 4 accredited epilepsy centers and highly-trained epileptologists participating in new research that guides and informs the care they provide. Multidisciplinary epilepsy care and research is complemented by expertise from Sutter Health network neuropsychologists and other specialists. To refer a patient, call 855-421-2904

California Pacific Medical Center, Sutter Medical Center, Van Ness Campus Sacramento 1101 Van Ness Avenue 2825 Capitol Avenue San Francisco, CA 94109 Sacramento, CA 95816