Abstract
Epilepsy surgery has proven to be a valuable therapy in the management of pharmacoresistant seizures in childhood. The goal of surgery is to identify and safely remove epileptogenic tissue and render the child seizure free. This is accomplished through intensive multimodality preoperative investigations designed to accurately localize the epileptogenic region and anatomically characterize functionally critical cortical areas subserving language, movement, and vision. Seizure semiology must be characterized and correlated with the results of electroencephalograhy (EEG) investigations and anatomic and functional imaging. Most pediatric epilepsy surgery centers perform video-EEG and magnetic resonance imaging (MRI). Positron emission tomography and ictal single photon emission computed tomography are also obtained frequently. Postprocessing of the MRI utilizing techniques such as voxel-based three-dimensional analysis has shown exceptional promise for detecting subtle malformative lesions involving the cortex and subcortical white matter. All of these initial investigations can be performed noninvasively and reviewed by a multidisciplinary team. Patients with a poorly delineated epileptogenic zone or seizures that are thought to be arising in or near critical cortex often require chronic extraoperative implantation of subdural or depth electrodes. Newer investigative modalities and further refinement of existing techniques hold promise for improved candidate selection and cortical localization.
| Original language | English |
|---|---|
| Pages (from-to) | 830-839 |
| Number of pages | 10 |
| Journal | Handbook of Clinical Neurology |
| Volume | 108 |
| DOIs | |
| State | Published - Sep 5 2012 |
Fingerprint
ASJC Scopus subject areas
- Clinical Neurology
- Neurology
Cite this
Preoperative evaluation in children for epilepsy surgery. / Duchowny, Michael; Cross, J. Helen.
In: Handbook of Clinical Neurology, Vol. 108, 05.09.2012, p. 830-839.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Preoperative evaluation in children for epilepsy surgery
AU - Duchowny, Michael
AU - Cross, J. Helen
PY - 2012/9/5
Y1 - 2012/9/5
N2 - Epilepsy surgery has proven to be a valuable therapy in the management of pharmacoresistant seizures in childhood. The goal of surgery is to identify and safely remove epileptogenic tissue and render the child seizure free. This is accomplished through intensive multimodality preoperative investigations designed to accurately localize the epileptogenic region and anatomically characterize functionally critical cortical areas subserving language, movement, and vision. Seizure semiology must be characterized and correlated with the results of electroencephalograhy (EEG) investigations and anatomic and functional imaging. Most pediatric epilepsy surgery centers perform video-EEG and magnetic resonance imaging (MRI). Positron emission tomography and ictal single photon emission computed tomography are also obtained frequently. Postprocessing of the MRI utilizing techniques such as voxel-based three-dimensional analysis has shown exceptional promise for detecting subtle malformative lesions involving the cortex and subcortical white matter. All of these initial investigations can be performed noninvasively and reviewed by a multidisciplinary team. Patients with a poorly delineated epileptogenic zone or seizures that are thought to be arising in or near critical cortex often require chronic extraoperative implantation of subdural or depth electrodes. Newer investigative modalities and further refinement of existing techniques hold promise for improved candidate selection and cortical localization.
AB - Epilepsy surgery has proven to be a valuable therapy in the management of pharmacoresistant seizures in childhood. The goal of surgery is to identify and safely remove epileptogenic tissue and render the child seizure free. This is accomplished through intensive multimodality preoperative investigations designed to accurately localize the epileptogenic region and anatomically characterize functionally critical cortical areas subserving language, movement, and vision. Seizure semiology must be characterized and correlated with the results of electroencephalograhy (EEG) investigations and anatomic and functional imaging. Most pediatric epilepsy surgery centers perform video-EEG and magnetic resonance imaging (MRI). Positron emission tomography and ictal single photon emission computed tomography are also obtained frequently. Postprocessing of the MRI utilizing techniques such as voxel-based three-dimensional analysis has shown exceptional promise for detecting subtle malformative lesions involving the cortex and subcortical white matter. All of these initial investigations can be performed noninvasively and reviewed by a multidisciplinary team. Patients with a poorly delineated epileptogenic zone or seizures that are thought to be arising in or near critical cortex often require chronic extraoperative implantation of subdural or depth electrodes. Newer investigative modalities and further refinement of existing techniques hold promise for improved candidate selection and cortical localization.
UR - http://www.scopus.com/inward/record.url?scp=84865606950&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84865606950&partnerID=8YFLogxK
U2 - 10.1016/B978-0-444-52899-5.00031-9
DO - 10.1016/B978-0-444-52899-5.00031-9
M3 - Article
C2 - 22939069
AN - SCOPUS:84865606950
VL - 108
SP - 830
EP - 839
JO - Handbook of Clinical Neurology
JF - Handbook of Clinical Neurology
SN - 0072-9752
ER -