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 journalArticle

2 Citations (Scopus)

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

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Epilepsy
Seizures
Group II Malformations of Cortical Development
Anterior Temporal Lobectomy
Therapeutics
Malformations of Cortical Development
Generalized Epilepsy
Motor Cortex
Syncope
Temporal Lobe
Single-Photon Emission-Computed Tomography
Positron-Emission Tomography
Electroencephalography
Magnetic Resonance Spectroscopy
Language
Referral and Consultation
Pediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Duchowny, M. S., Resnick, T. J., Jayakar, P., Alvarez, L. A., Dean, P., Gilman, J., ... Witt, J. (1997). Surgical treatment of epilepsy in childhood. International Pediatrics, 12(2), 106-112.

Surgical treatment of epilepsy in childhood. / 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.

In: International Pediatrics, Vol. 12, No. 2, 01.12.1997, p. 106-112.

Research output: Contribution to journalArticle

Duchowny, MS, Resnick, TJ, Jayakar, P, Alvarez, LA, Dean, P, Gilman, J, Morrison, G, Prats, AR, Altman, N, Birchansky, S, Yaylali, I & Witt, J 1997, 'Surgical treatment of epilepsy in childhood', International Pediatrics, vol. 12, no. 2, pp. 106-112.
Duchowny MS, Resnick TJ, Jayakar P, Alvarez LA, Dean P, Gilman J et al. Surgical treatment of epilepsy in childhood. International Pediatrics. 1997 Dec 1;12(2):106-112.
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. / Surgical treatment of epilepsy in childhood. In: International Pediatrics. 1997 ; Vol. 12, No. 2. pp. 106-112.
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