Navigating an epilepsy diagnosis and surgery: Geni’s story

Life was proceeding right on schedule for self-described “drama kid” Genevieve Masson. The 16-year-old, who goes by “Geni,” went to class, hung out with friends and spent time rehearsing musical theater at her high school.

“It was really a normal, not-so-exciting life,” she says.

school photo before epilepsy diagnosis
Life looked typical for Geni, pictured here in her eighth grade photo, before her first seizure.

But two years ago, when Geni was 14, something changed. A small lesion that had been in her brain since birth began making itself known. One night, she woke up and couldn’t move. She figured she was caught in a moment of sleep paralysis and didn’t give it too much thought.

Things quickly turned far more serious. A few days later, Geni was feeling tired at school and decided to take a nap in her coach’s office. That’s when she had her first full-on seizure.

Geni has no memory of what happened next, but those around her became alarmed as her body shook uncontrollably. A teacher called 911 and the next thing Geni knew, she was in an emergency room.

An MRI revealed nothing, as did visits to pediatricians. But not only did the seizures continue, they were occurring more often. The more severe ones occurred at night, while less noticeable ones were happening many times a day. Ultimately, she was diagnosed with epilepsy, but she wasn’t receiving the expert care she needed at nearby hospitals.

“I remember the day she had her first seizure. It was December 18,” says Susan Masson, Geni’s mom. “By that January, there were a couple more. It got to be about 15 to 20 a day. We knew we needed to be at CHOC. We needed to be at a place where we could be with an epileptologist.”

The Massons felt lucky to live fairly close to CHOC, home to one of the nation’s premier epilepsy centers for young people. CHOC’s Comprehensive Epilepsy Program was the first in California to be named a Level 4 epilepsy center by the National Association of Epilepsy Centers, the highest level available. That distinction means that CHOC has the professional expertise and facilities to provide the highest level medical and surgical evaluation and treatment for patients with complex epilepsy.

It was at CHOC that the Massons met Dr. Maija-Riikka Steenari. A pediatric neurologist, Dr. Steenari is an epilepsy specialist, also known as an epileptologist.

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Dr. Maija Steenari, pediatric epileptologist at CHOC

“It’s a fascinating field,” Dr. Steenari says of pediatric neurology and epilepsy. “The combination of working with brains and kids together is the best fit for me.”

What exactly is epilepsy? Basically, parts of the brain go haywire and emit unwanted electrical signals that can cause convulsions and seizures of varying strength. As Dr. Steenari describes it, it’s “a clump of brain cells that don’t quite work the way they’re supposed to, or a cluster of cells in the wrong place. They’re really irritable. They’re known to cause trouble.”

Epilepsy can be the result of brain injury, stroke or, in Geni’s case, a slight anomaly that was present since birth.

November is National Epilepsy Awareness Month, a time to remind people that epilepsy is both fairly common — nearly 25% of the population will experience recurring seizures in their lifetime — and it’s often treatable.

Like others diagnosed with epilepsy, Geni’s first option was medication. She was prescribed anti-seizure medicines, but they didn’t work.

Geni undergoes EEG monitoring at CHOC
Geni underwent EEG monitoring at CHOC to measure electrical activity in her brain.

“Medication works about 60 to 70% of the time,” Dr. Steenari says. “But adding more medications doesn’t always work. A second medication only works about 10% of the time. So, can we do something else to help them with their seizures? That’s where surgery comes into play.”

Having seizures meant that Geni was missing a lot of school, would not be able to drive and couldn’t be left alone. But her family and friends rose to the occasion and helped when they could. And Geni did her best to be a regular teenager.

“I was trying to lead a normal life,” she says. “I would still go to rehearsals.”

Geni needed two surgeries, the first one to determine exactly where the problem was. Dr. Joffre Olaya was her pediatric neurosurgeon.

Geni’s hospital room before epilepsy surgery
When Geni spent time at CHOC, her friends made special decorations for her room to show their support and cheer her up.

“We have these grids that we can put on the surface of the brain,” Dr. Steenari says. “We can map where the seizures are coming from within a few millimeters. We could make a very detailed map.”

The lesion was right next to the part of Geni’s brain that controls language. If her surgeon didn’t have an exact spot to operate, she could lose the ability to speak or write. But Geni was willing to take the risk. Each seizure could cause more damage to her brain and Geni wanted them to stop.

“The doctor said each seizure would do damage to my brain,” Geni said. “I don’t like having constant damage to my brain done. If surgery can take me back to where I can’t write or speak well, I was willing to take the chance.”

Geni prepares for surgery
Geni was all smiles leading up to her second epilepsy surgery.

The second surgery came a few weeks later. Doctors successfully removed the lesion, but Geni faced a number of challenges after surgery that her family was told ahead of time were possibilities. Geni lost automatic movement of her right hand, so she couldn’t do with her right hand what other people do without thinking about it. She was 15 at the time, so before surgery, she had long ago mastered writing without thinking about how to shape each letter. After surgery, she knew how letters should look, but she couldn’t make them. She also couldn’t tie her shoes, brush her hair or teeth, button or zip her clothes, or feed herself.  But Geni and her family treated these more like challenges than setbacks, and occupational therapy helped.

welcome home signs epilepsy surgery
To welcome Geni home after epilepsy surgery, her siblings decorated her bedroom.

“A few weeks after surgery, we went to the library and we got some preschool books on how to write. It was quite frustrating, but luckily, my brain still knew how to do it. It just needed to create new pathways. As soon as I did it, it got easier,” Geni says.

workbooks to help regain skills after epilepsy surgery
Preschool workbooks helped Geni re-master writing after epilepsy surgery.

Talking was hard after surgery, too. Geni would know what she wanted to say, but finding the right words took a little more time than it used to.

“Surgery had knocked over her file cabinet of words,” Susan explains of her daughter’s struggles post-surgery, which got better with speech therapy.

Geni’s family was with her every step of the way. It was heart-wrenching for her parents to see their daughter suffer, but they’re proud of how she handled her journey.

“I cry every time I remember how hard this was, and then I laugh at how much Geni thought it was simply annoying what she had to relearn. These kids are fearless little warriors,” Susan says of her daughter. “She’s a bubbly, vibrant, friendly girl. People love her. I don’t think it ever occurred to her that there was another way to manage through this. The limitations of life when you’re living with epilepsy can be staggering, but we didn’t have time to realize them. As soon as it came up, it ended. We got hit by a Mack truck and then it ended.”

Geni and family in 2019 before surgery
Geni and her family on vacation in 2019 before her epilepsy surgery.

Today, Geni has been seizure-free for 14 months. And while her right arm tires easily and she still sometimes has trouble finding the right words to say, someone meeting her for the first time wouldn’t notice.

Geni back on stage after epilepsy surgery
Geni was back on stage a few months after epilepsy surgery.

“I have my driver’s permit and I’m learning how to drive,” Geni says. “That’s where I am right now. I’m working on a project for my film class and also an online play “Clue.”

Geni should continue to improve with time.

“She’s made remarkable recovery,” Dr. Steenari says. “She’ll continue to get better. If we had let those seizures continue, she would have ended up being much worse in the future.”

Wired for hope

Every morning when she awakes, Sydney Amato begins her daily battle with her body.

If she’s lucky, the 16-year-old will have gotten a handful of hours of uninterrupted sleep – dreaming, perhaps, of doing what most healthy kids her age take for granted:

Hanging out with friends. Going to school. Learning to drive.

Because of a neurological condition called dystonia, Sydney, who is in excellent cognitive health but speaks and walks with some difficulty, suffers from involuntary and near-constant contraction of muscles in her neck, arms, legs and trunk.

Her mind is unable to control the painful jerking that makes most of her body twist and go rigid, her muscles moving out of normal sequence.

Born a right-hander, she can feed herself with some struggle using her left hand. She wants to dress and put on makeup herself, but those normally simple tasks become lengthy ordeals.

“My body fights me all the time,” says Sydney, trying to distract herself in her hospital bed one morning by watching an old episode of “Keeping Up with the Kardashians.” Listening to her favorite music – Ariana Grande, Lauren Daigle, Drake – can only temporarily transport Sydney away from her debilitating condition.

“She knows what she wants to do,” says her father, Louis. “But her body won’t let her.”

Specialists at CHOC are working hard to change that.

CHOC patient and her father
Sydney, pictured with her father.

A first for CHOC

Recently, a team led by Dr. Terence Sanger, a physician, engineer and computational neuroscientist who joined CHOC in January 2020 as its vice president of research and first chief scientific officer, and Dr. Joffre E. Olaya, CHOC’s functional restorative neurosurgeon, implanted several temporary electrodes into Sydney’s brain. Collaborating with CHOC physicians was CHLA neurosurgeon Dr. Mark Liker.

Dr. Terrence Sanger, chief scientist at CHOC Children's

The surgery marked the first time a patient with a movement disorder at CHOC underwent a procedure called deep brain stimulation (DBS).

Working in perfect harmony as a team, Dr. Sanger and Dr. Olaya oversaw the first portion of a three-stage surgery on Sydney. As the surgeon, Dr. Olaya placed the leads following advice from Dr. Sanger, the neurologist, on where they should go.

 In the procedure, millimeter-thick electrodes were precisely positioned into the basal ganglia region of Sydney’s brain – about 3 inches deep. The surgery involved the use of the ROSA robot, the same tool that has been used during brain surgery on epilepsy patients at CHOC since 2015.

Considered one of the most advanced robotized surgical assistants, ROSA — which stands for robotic operating surgical assistant — includes a computer system and a robotic arm. It’s a minimally invasive surgical tool that improves accuracy and significantly reduces both surgery and anesthesia time.

The ROSA robot helped with implanting and targeting the electrodes and a portable operating-room CT scanner confirmed their position.

Turning down the volume

 DBS is designed to ease Sydney’s condition by sending electrical currents to jam her malfunctioning brain signals.

Think of turning down the volume on your car radio.

“Nobody really understands the cause of dystonia,” Dr. Sanger explains, “but there’s probably too much electrical stimulation going on in the motor areas of the brain. We’re trying to calm down that extra noise.”

Although DBS dates to the 1960s, it wasn’t until the 1980s that the modern era of using it to treat adult patients with tremor and Parkinson’s disease began.

In 2000, Dr. Sanger, working with engineers, data scientists, neurosurgeons and others, began implanting electrodes in pediatric patients.

Instead of the established method of placing the leads at predetermined sites and hoping they worked, Sanger and his team, just as they did in Sydney’s case, placed temporary leads to best assess where they should go permanently based on patient response.

In 2016, Dr. Sanger began honing DBS to treat children with dystonia. Before the surgery on Sydney, Dr. Sanger had overseen DBS on 26 children using the same three-stage technique. He says 80% of those children have seen successful results.

Early signs

Sydney began showing symptoms of dystonia – tremors in her hands – when she was 5 ½ years old.

A year later, she was using a wheelchair. She had her first brain surgery at age 7.

Since then, “she’s been all over the U.S.” seeking the right treatment for her condition after several setbacks, her father says.

But her condition was not improving.

Early this year, a neurologist in Kansas City, Missouri, recommended that Sydney see Dr. Sanger.

“I asked him, ‘If Sydney was your kid, where would you go?’” Louis Amato recalls. “He said, ‘Hands down, Dr. Sanger.’”

The COVID-19 pandemic pushed Sydney’s surgery to mid-August.

Sydney already had two electrodes in her brain that were only partially working when she came to CHOC in early August for surgery.

After two extensive run-throughs with their team, Dr. Sanger and Dr. Olaya, in a six-hour procedure that at one point required nearly 20 people in the operating room, implanted more electrodes to give Sydney a total of nine.

Dr. Joffre Olaya, a pediatric neurosurgeon at CHOC Children's
Dr. Joffre Olaya

After surgery, optimism

On Thursday, Aug. 20, six days after Sydney’s surgery, Dr. Sanger stopped by her room at CHOC Hospital. The room was decorated in purple, Sydney’s favorite color.

Dr. Sanger greeted her as CHOC staff members, joined by members of Sanger Lab, Dr. Sanger’s research laboratory that conducts research in pediatric movement disorders, prepared to have Sydney walk back and forth down a hallway while connected to electrical equipment programmed to record signals in her brain and muscles.

A thick coil of multicolored wires snaked from under a large white bandage covering Sydney’s head. Extending about 6 feet, the wires were plugged into specialized recording equipment controlled by Jennifer MacLean, a CHOC pediatric nurse practitioner whose job was to manipulate the strength of electrical charges affecting the four points of contact on each electrode.

The goal: determine which charges worked best and on which electrodes.

“It could have turned out that the DBS procedure made no difference,” Dr. Sanger says. “But we’ve seen a very good response in Sydney.”

For example, her once mostly useless right hand was working much better.

“It gives you goosebumps,” Louis Amato says.

After taking a bite of a veggie burger and sipping some water, Sydney started to walk.

Following her were seven CHOC and Sanger Lab specialists.

“Go nice and slowly,” Jennifer told Sydney. “You’re going too fast for us!”

Perhaps Sydney was anxious to get back to riding Tigger, a quarter horse, in her hometown of Carthage, Missouri. She has been riding him for six months.

CHOC patient horseback riding
Sydney is eager to get back to riding her favorite horse, Tigger.

“Her balance isn’t bad on the horse,” says Louis Amato.

Sydney also loves to tan by her pool and swim.

What she wants most, however, is to be freed from her body so she can return to school and do what most teens enjoy.

“It’s stressful,” says her mother, Angie. “She has a lot of friends her age, but she can’t do a lot of the things they do. She has her days when she can get really upset.”

Now, however, working with Dr. Sanger, Dr. Olaya and the entire team at CHOC, the Amatos are more optimistic than ever.

“We’re hopeful that this is going to be a big life-changer for her,” Angie Amato says. “That would be the best thing that could ever happen – better than winning the lottery.”

‘The A-Team’

After crunching numbers for a week to assess which of the nine electrodes proved to be the most effective based on how Sydney responded to varying degrees of electrical currents, Dr. Sanger and his team settled on four electrodes that were permanently used to treat her condition – three new ones, and one existing one.

The team performed this second surgery on Sydney in late August.

In the third and final surgery, successfully completed in early September, a rechargeable generator that powers the DBS leads was implanted in Sydney’s chest.

“As we get better and better at this and as the technology progresses, we’ll be able to do this on kids who are less sick than Sydney,” Dr. Sanger says.

Dr. Sanger and Dr. Olaya are poised to dramatically improve the lives of many more patients like Sydney at CHOC.

“I’m really excited that we will be doing more of these procedures to help pediatric patients with movement disorders and significantly improve their quality of life,” says Dr. Olaya. “I look forward to continuing to provide this type of personalized care.”

a CHOC patient poses with her mom
Sydney, pictured with her mother.

Angie and Louis Amato say Sydney has never gotten this much special attention during her 11-year-plus medical journey.

“Here at CHOC,” Louis Amato says, “we feel like we’re with the A-Team.”

Says Sydney: “I’ve never felt this much confidence and this good about treatment before.”

CHOC recognized as one of nation’s best children’s hospitals

best-childrens-hospitals-7specialties

CHOC is one of a select number of pediatric facilities nationwide to have been ranked today as a best children’s hospital by U.S. News & World Report.

The following CHOC specialties are honored in the 2020-21 Best Children’s Hospitals rankings: neonatology; cancer; diabetes and endocrinology; neurology and neurosurgery; orthopaedics; pulmonology; and urology. Both orthopaedics and diabetes and endocrinology earned a “Top 20” spot. 

“At CHOC, we are committed to the highest standards of care, safety and service – and this honor reflects that unwavering dedication,” said Dr. James Cappon, CHOC’s vice president, chief quality and patient safety officer and interim chief medical officer. “Not only does this recognition of our excellence in these subspecialties, including two on the top 20 lists, validate our efforts, but it also offers our patients and families additional assurance of our commitment to their health and safety.”

The Best Children’s Hospitals rankings were introduced by U.S. News in 2007 to help families of children with rare or life-threatening diseases find the best medical care available. Only the nation’s top 50 pediatric facilities are distinguished in 10 pediatric specialties, based on survival rates, nurse staffing, procedure and patient volumes, reputation and additional outcomes data. The availability of clinical resources, infection rates and compliance with best practices are also factored into the rankings.

The U.S. News Best Children’s Hospitals rankings rely on clinical data and on an annual survey of pediatric specialists. The rankings methodology factors in patient outcomes, such as mortality and infection rates, as well as available clinical resources and compliance with best practices.

Learn more about Best Children’s Hospitals rankings.

6 headache hygiene tips for children

Headaches usually are brief and can be caused by many things, including too little sleep, stress, or a concussion. Some headaches last longer and come with other symptoms. Very rarely, headaches can be a sign of something serious. Learn more about different types of headaches in children, and what parents can do to help.

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Dr. Mary Zupanc, a pediatric neurologist and co-medical director of the CHOC Neuroscience Institute

Dr. Mary L. Zupanc, a pediatric neurologist and co-medical director of the CHOC Neuroscience Institute, offers tips for parents on headache hygiene— or healthy habits to reduce the likelihood, frequency and severity of headaches.

Maintain regular sleep habits

If your child goes to sleep and wakes up at approximately the same time every day, Dr. Zupanc says, their likelihood of suffering from a headache decreases. Bedtime and wake-up times should not vary significantly from weekday to weekend. Adolescents have sleep phase delay, meaning their brains do not want to go to sleep until later at night and they want to sleep in. This is normal behavior, but school schedules rarely accommodate this adolescent neurobiology.

Exercise regularly

Children should get at least 30-40minutes of physical activity three to four days per week, she adds. However, the full 30-40 minutes doesn’t need to be all at once. You can break it down into smaller sessions.

Eat a well-balanced diet. Avoid meal skipping.

A child’s eating habits can have a direct effect on their susceptibility to headaches, Dr. Zupanc says. To encourage kids to eat healthy, including them in the food preparation process whenever possible—from meal planning to grocery shopping to prepping fruits and vegetables in the kitchen. Kids are more likely to eat what’s in front of them if they feel like they had a choice and hand in preparing it.

Some foods may trigger headaches in children. Limit the intake of processed or fried foods. Overly restrictive diets may prompt an unhealthy relationship with food or body image. If you are unsure if certain foods may be triggering your child’s headaches, consult your pediatrician.

Stay well hydrated

Headaches are commonly caused by dehydration. There is a link between increased water intake, decreased headache severity, and improved quality of life. At CHOC, we recommend that children drink the number of 8-ounce cups of water equal to their age, with a maximum of 64 ounces for children over age 8. This means your 1-year-old would drink one 8-ounce glass or water, your 5-year-old would drink five 8-oz glasses of water, etc.

Limit caffeine intake

Caffeine tolerance differs from person to person, but the general recommendation is 200 to 300 milligrams per day. A standard cup of coffee has around 100 milligrams of caffeine, compared to a large coffee drink that can have over 400 milligrams of caffeine. If you have too much caffeine, you can experience headaches, heart palpitations, elevated blood pressure, insomnia, or irritability.

Play

Yes, really! Kids are busier than ever these days, and an over-scheduled child is likely to suffer stress, which can lead to headaches, Dr. Zupanc says. Spending time outdoors, reading for pleasure, and playing sports for fun rather than in a competitive environment are all good ways to help cut down on stress, she says. In addition, screen time — including tablets and smartphones —should be limited. Learn more about screen time limits for kids.

Mindfulness, or relaxation techniques, can help kids and teens build the coping skills they need to address issues like stress and anxiety, Zupanc adds. Learn more about mindfulness tips for your children.

Studies have shown that cognitive behavioral therapy, in combination with preventive medication, has helped adolescents with chronic migraine headaches.

Keep a journal

If your child experiences frequent headaches, keep a journal to track their headaches so you can identify a pattern, and show this to your child’s pediatrician. In your headache journal, keep track of:

  • Headache start date and time
  • What happened just before the headache?
  • How much did your head hurt, on a 0-10 pain scale?
  • Where did your head hurt?
  • Was the pain throbbing (pounding) or dull?
  • Were there any other signs or symptoms associated with the headache, such as a change in vision, tingling of an arm or leg, or weakness?
  • What did you feel just before and during the headache?
  • What did you do to make yourself feel better?
  • Did you feel better, on a 0-10 pain scale?
  • Headache end date and time

Your child’s doctor may adjust their diet, headache hygiene routine, or their over-the-counter pain relief regimen, Dr. Zupanc advises.

There are some, albeit rare, situations where a child’s headache warrants a trip to the emergency department, Dr. Zupanc says, including:

  • A thunderclap headache: severe, sudden onset of pain that occurs anywhere in the head and grabs your attention like a clap of thunder. Pain usually peaks within 60 seconds to a few minutes.
  • Any headache that comes with weakness or numbness on one side of the body, changes in consciousness or awareness, or change in balance.
  • Blurred, double or loss of vision that persists after the headache resolves.

Sporadic headaches rarely require brain neuroimaging, such as a CT scan or MRI scan of the brain.

Frequent headaches that are increasingly severe can suggest an underlying brain problem. Brain imaging may be necessary. If your child experiences the following symptoms, ask your pediatrician for a referral to a pediatric neurologist for further evaluation and possible imaging:

  • Headaches associated with weakness or numbness in an arm or leg, or balance problem. In this case, immediate follow-up care is warranted.
  • Headaches that wake a child out of sleep
  • Headaches associated with projectile vomiting
  • Headaches that increase with Valsalva maneuver (such as bearing down for a bowel movement)
  • Headaches associated with a seizure

6 do’s and don’ts of concussion

If your child experiences a concussion, it can be scary to think about the effects on their developing brain. The good news is, more than 85% of concussions heal well if managed properly early on.

“Early, appropriate treatment prevents kids from having to come see me as a neurologist,” says Dr. Sharief Taraman, pediatric neurologist and director of the CHOC Concussion Program. “It’s important to do as much as we can to prevent kids from getting a concussion, prevent reinjury, and treat them as aggressively and appropriately as possible in the early intervention stages.”

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Dr. Sharief Taraman, a pediatric neurologist at CHOC.

Follow these do’s and don’ts for proper prevention and treatment of concussion. If your child does sustain a concussion, be sure to see your pediatrician as soon as possible.

Do protect a young brain

Athletes should be taught safe playing techniques, equipment maintenance and to follow the rules of the game. Always wear a helmet while playing contact sports like football, hockey and lacrosse, and during activities like horse riding, biking, skateboarding or snowboarding. Helmets should fit correctly and be in good condition.

Don’t miss the signs

A concussion isn’t always obvious. Watch for these signs in your child or teen, especially while they are participating in sports. Symptoms may take up to a day to appear after an incident.

  • Headache
  • Nausea or vomiting
  • Balance problems
  • Dizziness
  • Visual problems
  • Fatigue or drowsiness
  • Sensitivity to light or noise
  • Numbness or tingling
  • Dazed or stunned
  • Irritability
  • Sadness
  • More emotional
  • Nervousness
  • Trouble falling asleep
  • Feeling mentally “foggy”
  • Feeling slowed down
  • Confused about recent events
  • Sleeping less or more than usual
  • Difficulty concentrating or remembering
  • Forgetful of recent information or conversations
  • Answers questions slowly or repeats questions

Seek emergency care immediately if your child or teen has experienced unconsciousness for any amount of time or has changes in alertness, convulsions or seizures, muscle weakness, persistent confusion, repeated vomiting, unequal pupils, unusual eye movements or walking problems.

Do sit on the sidelines

The most important thing your child should do if they are injured during a sports activity is to immediately stop playing. It’s crucial that they avoid more hits, jolts, shakes or bumps to the head or spine. Getting back in the game is not worth the risk. Remember, the signs of concussion aren’t always clear, so when in doubt, sit it out.

Athletes may not want to tell their coach if they had a concussion. Encourage them to come forward if they have an injury, or if they notice a teammate is injured. Young athletes should never ignore a head injury or impact to the head.

Don’t skip treatment

Even a mild concussion should be evaluated by a doctor. Get in to see your child’s pediatrician as soon as possible.

When a concussion is severe or symptoms won’t go away, talk to your doctor about a referral to the CHOC Concussion Program, which includes pediatric sports medicine specialists, neurologists, neurosurgeons, neuropsychologists and rehabilitation therapists who are all trained in concussion management.

Don’t rush recovery

Rest is important immediately following a concussion. For 24-48 hours, your child should stay home from school and get plenty of quiet time and mental rest. This includes limiting activities like:

  • Television
  • Texting
  • Social media
  • Reading
  • Driving
  • Doing homework
  • Social interaction
  • Attending loud events

After the first 24-48 hours, light activities may help speed up recovery. Most children should be able to tolerate some school after a few days. If they need to miss more school than that, contact the school and your doctor to help intervene with short-term adjustments. Before returning to sports, be sure that symptoms have resolved and get medical clearance from your child’s doctor.

Do prevent future injury

Parents, coaches and athletes should be extra cautious to prevent future concussions. One concussion is rough enough, but additional injury is even worse. Research has shown that repeated jars to the head can have long-lasting effects on the brain. And, if a child or teen suffers a second concussion before the first concussion heals, they are at risk for Second Impact Syndrome, a life-threatening condition.

“The CDC has called concussions an epidemic in the United States,” Dr. Taraman says. “Kids really do get into trouble if a concussion is not recognized, and if we don’t take the proper steps to get them better and avoid those second injuries, which can be catastrophic.”