Pediatric epilepsy surgery

Michael Duchowny

Research output: Contribution to journalArticle

Abstract

Epilepsy surgery has become an important therapeutic option for children with medically resistant epilepsy. Localization-related seizures with or without secondary generalization are treatable by temporal lobectomy, extratemporal resection, or hemispherectomy, with the choice of procedure dictated by the location and extent of the epileptogenic zone. Extratemporal resections are much more common in children than in adults. Favorable rates of postoperative freedom from seizures are possible in all of the childhood excisional procedures. Although prenatally acquired malformations of cortical development are the most prevalent histologic abnormality in children undergoing resection, in a significant proportion, seizures occur in the setting of recognizable epilepsy syndromes. In contrast, the generalized epilepsies are not amenable to resective procedures. Although experimentally justified, corpus callosotomy is palliative except in some cases of atonic seizures, but other seizure types are unimproved, and ongoing medication is the rule. The preoperative evaluation relies on high-resolution magnetic resonance and functional imaging with single photon emission computed tomography, positron emission tomography, and spectroscopy to help to define the epileptogenic region, especially in extratemporal nonlesional cases. Subdural EEG monitoring often contributes definitive localizing information and facilitates cortical mapping. Earlier surgery improves psychosocial and rehabilitative status, whereas medical intractability predisposes patients to psychosocial deterioration.

Original languageEnglish
Pages (from-to)4-12
Number of pages9
JournalNeurologist
Volume5
Issue number1
StatePublished - Jan 1 1999

Fingerprint

Epilepsy
Seizures
Pediatrics
Hemispherectomy
Malformations of Cortical Development
Generalized Epilepsy
Single-Photon Emission-Computed Tomography
Positron-Emission Tomography
Electroencephalography
Spectrum Analysis
Magnetic Resonance Imaging
Therapeutics

Keywords

  • Epilepsy
  • Epilepsy surgery
  • Pediatrics

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Duchowny, M. (1999). Pediatric epilepsy surgery. Neurologist, 5(1), 4-12.

Pediatric epilepsy surgery. / Duchowny, Michael.

In: Neurologist, Vol. 5, No. 1, 01.01.1999, p. 4-12.

Research output: Contribution to journalArticle

Duchowny, M 1999, 'Pediatric epilepsy surgery', Neurologist, vol. 5, no. 1, pp. 4-12.
Duchowny M. Pediatric epilepsy surgery. Neurologist. 1999 Jan 1;5(1):4-12.
Duchowny, Michael. / Pediatric epilepsy surgery. In: Neurologist. 1999 ; Vol. 5, No. 1. pp. 4-12.
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