Treatment methods

Specialising in hard-to-treat epilepsy

Since the 1980s, we have looked after more than 10,000 young patients with hard-to-treat epilepsy at our epilepsy centre. Surgery is not always necessary or possible. Many forms of epilepsy can be successfully treated with medication. Thanks to the experience of our consultants and the high degree of specialisation at our epilepsy centre, we are able to offer many children excellent and most importantly personalised epilepsy treatment.

Even after discharge, we are happy to continue your child's care: personalised aftercare programmes and an epilepsy outpatient clinic open to all patients ensure the best possible support right up into adulthood.

Conservative treatment methods

Our medical facilities

Epilepsy outpatient clinic 

Patients with suspected epilepsy can present to our epilepsy outpatient clinic. We carry out detailed diagnostic tests and, in mild cases, are able to initiate the first stages of treatment with medication.

We are also able to provide aftercare following procedures and the regular monitoring of medication levels at this clinic.  

Day hospital

The day hospital offers epilepsy treatment for children and adolescents, but also young adults who often also have multiple disabilities. The day hospital form of treatment has the advantage that the patients go home in the evening and are able to spend the night in their familiar environments. They also spend weekends and public holidays at home. They can stay at the hospital for up to several weeks.

Hospital school

Our clinic school is not solely about making sure our patients do not miss out on too much education, be it primary or secondary. Often, finding the right form of learning after neurological problems develop is more important. The teaching is delivered in close consultation with the patient's home school and can be provided in one-to-one or group lessons. Children and adolescents attending the day hospital also participate in the lessons.

Conservative epilepsy treatment: drug treatment

Our experienced treatment team has a broad array of modern medicines at its disposal. We choose these carefully according to your child's diagnosis and tailor the dose accordingly. The success of epilepsy treatment is monitored regularly, with the medications being adjusted or changed as required. 

Conservative epilepsy treatment: special nutritional therapies

In certain cases, a change of diet can reduce the number of epileptic seizures. One of the positive side-effects of this is that medications that have been needed up until that point can be reduced, or even stopped altogether. The modified Atkins diet or ketogenic diet are very easy to follow in an everyday setting with the right guidance, and studies have shown that they can reduce the number of seizures significantly. Our experienced nutritional consultants support families with diet change programmes.

Surgical treatment methods

Surgical epilepsy treatment

At Schoen Clinic, we have tremendous experience of surgical procedures on the brain: in the last year alone, our consultants carried out over 400 operations on children and adults. 

An operation on the brain calls for a lot of high-tech medicine, in order to ensure that the procedure is as safe as possible. As a result, data from the structural and, where available, functional MRI scans is fed into special, computer-navigated systems (neuro-navigation). Our consultants are then able to monitor precisely during the operation where they are in the brain, and where central nerve pathways run. After the surgery, electrocorticography is often taken directly from the surface of the brain in order to determine whether there is still any detectable epileptic activity.   

Before the decision to operate is made, however, neuro-paediatricians, radiologists, neuro-psychologists and neurosurgeons consult together in a case conference. If you have consented to an operation, the surgeon looking after your child will support you and your child from the explanation of the procedure to the surgery itself and beyond.

Possible procedures:

  • Hemispherotomy to separate parts of the brain
    If the epilepsy originates from a complete half of the brain and threatens to harm the healthy half, our epilepsy surgeons will carry out a hemispherotomy. With this procedure, the diseased half of the brain is separated off without harming the healthy half. This operation is less drastic than a complete removal and for many patients means complete freedom from epileptic seizures.
  • Lesionectomy
  • Lobectomy
  • Callosotomy

Treatment of epilepsy that is resistant to treatment

Unfortunately, there are some patients in whom even our consultants are unable to see any prospect of reducing the number of seizures by performing surgery. In this case, our team will not only communicate what they know about the disease, but they will also ensure, for example, that the patient does not suffer any academic or social disadvantages. 

Practical support for day-to-day living

We will provide you and your child with practical support for day-to-day living that is as customised as possible to your needs. The aim is to encourage your child's independence and to formulate new perspectives and realistic therapy goals. Children with refractory epilepsy need life-long care. For adolescents, our consultants will plan the handover to adult medicine so that the paediatric neurologist is able to communicate directly with the adult neurologist.

Vagus nerve stimulation

If medications or surgery fail to produce the desired result, vagus nerve stimulation may produce an improvement in the symptoms. With this, a small device, similar to a cardiac pacemaker, is implanted. This sends electrical impulses to the vagus nerve, which connects the brain and almost all of the internal organs. The electrical impulses inhibit the activity of the brain and therefore reduce the number of seizures. 

Option for the future: deep brain stimulation

With this technique, a special core area of the interbrain is stimulated: a small electrical device, similar to a cardiac pacemaker, is implanted and uses two fine electrodes to stimulate the region of the brain with electrical impulses. Complete freedom from seizures may only be achieved in individual cases, but the number of seizures can often be reduced.