Epilepsy surgery in the first three years of life

M. Duchowny, P. Jayakar, T. Resnick, A. S. Harvey, L. Alvarez, P. Dean, J. Gilman, I. Yaylali, G. Morrison, A. Prats, N. Altman, S. Birchansky, J. Bruce

Research output: Contribution to journalArticlepeer-review

212 Scopus citations


Purpose: Partial seizures in early postnatal life may be catastrophic and associated with poor long-term outcome. Epilepsy surgery can alleviate partial seizures in older children and adults, but there is little experience with surgical therapy in infancy apart from hemispheric epilepsy syndromes. Methods: We analyzed the results of cortical resection to treat medically refractory partial epilepsy in 31 children (16 boys, 15 girls) aged <3 years (mean, 18.3 months). Subjects were included only if seizure relief was the primary indication for surgery. Results: Follow-up of at least 1 year (mean, 4.6 years) in 26 patients revealed that 16 were seizure-free, 4 had >90% seizure reduction, and 6 had <90% reduction. There was no significant difference in seizure outcome between hemispherectomy/multilobar resections and lobar resections or temporal versus extratemporal resection. Seizure outcome was independent of the amount of cortex removed in nonlesional patients. Only the presence of a discrete lesion on preoperative neuroimaging correlated with a favorable outcome. Family perceptions of accelerated development in seizure-free patients were not confirmed on developmental assessment. Conclusions: We conclude that cortical resection often benefits very young children with catastrophic partial seizures, but does not guarantee enhanced neurological development. The location and extent of the excised cortex may not be critical as long as the entire epileptogenic region and lesion are removed.

Original languageEnglish (US)
Pages (from-to)737-743
Number of pages7
Issue number7
StatePublished - Jul 1998


  • Cortical resection
  • Epilepsy surgery
  • Hemispherectomy
  • Partial seizures
  • Young children

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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