Surgical treatment of epilepsy in childhood

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

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

Epilepsy surgery has become an important therapeutic option for children with medically resistant epilepsy. Anterior temporal lobectomy was the earliest surgical procedure to offer seizure control and reversal of social disability in adults. Most children have extratemporal seizures and modern diagnostic techniques allow surgery to be performed outside the temporal lobe. Functional imaging using single photon emission computed tomography (SPECT), positron emission tomography (PET), and nuclear magnetic resonance spectroscopy (NMR) assist in defining the epileptogenic region, especially in nonlesional cases; subdural EEG monitoring provides definitive localizing information if the noninvasive workup is nondiagnostic. Subdural grids also facilitate mapping of motor and language cortex. Prenatally acquired developmental lesions including cortical dysplasia and neuronal migration disorders are the most prevalent histologic abnormality, with infants and young children showing particularly widespread involvement. The outcome of epilepsy surgery in childhood is generally favorable and at least 80% of patients undergoing excisional procedures obtain complete seizure control or substantial improvement. Corpus callosotomy is palliative for the generalized epilepsies except for atonic drop attacks. Earlier surgery improves psychosocial and rehabilitative status and delaying surgical referral may predispose to psychosocial deterioration. Potential candidates should be referred as early as possible to centers specializing in pediatric epilepsy surgery.

Original languageEnglish (US)
Pages (from-to)106-112
Number of pages7
JournalInternational Pediatrics
Volume12
Issue number2
StatePublished - Dec 1 1997

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Duchowny, M. S., Resnick, T. J., Jayakar, P., Alvarez, L. A., Dean, P., Gilman, J., Morrison, G., Prats, A. R., Altman, N., Birchansky, S., Yaylali, I., & Witt, J. (1997). Surgical treatment of epilepsy in childhood. International Pediatrics, 12(2), 106-112.