Results and complications after reoperation for failed epilepsy surgery in children

Ellen G. Shaver, A. Simon Harvey, Glenn Morrison, Antonio Prats, Prasanna Jayakar, Patricia Dean, Michael Duchowny

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

The seizure outcome and neurological outcome in children who undergo reoperation for failed epilepsy surgery have not been well documented. This retrospective study evaluated 20 children who underwent a second resective surgery for recurrent seizures. Four categories of patients were identified: (1) extension of the initial resection was performed in 8 patients; (2) 5 patients underwent lobectomy or corticectomy in a region remote from the original surgical site; (3) multilobar resection which may have included further resection of the initial procedure was accomplished in 4 patients; (4) hemispherectomy was performed in 3 patients. Patients with reoperation in the same lobe as the first procedure (group 1) had a 62% seizure-free rate, while 44% of patients in groups 2 and 3 were free from seizures at follow-up evaluation. Patients undergoing hemispherectomy had a 67% seizure-free rate. Significant unexpected neurological deficits occurred in 3 patients who underwent multilobar resection at reoperation. Complications included motor and language deficits. Reoperation for intractable partial epilepsy is beneficial in selected children. Patients who require multilobar resections may have higher risk of postoperative neurological deficit than those patients with reoperation in one lobe. These factors may be useful in counseling parents of children considering reoperation for recurrent epilepsy.

Original languageEnglish (US)
Pages (from-to)194-202
Number of pages9
JournalPediatric Neurosurgery
Volume27
Issue number4
DOIs
StatePublished - Jan 1 1997

Keywords

  • Children
  • Epilepsy surgery
  • Reoperation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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