[Role of pediatrician in surgical treatment of children with intractable seizures].
Surgery is a useful strategy in the management of intractable and disabling seizures in childhood. Identification of suitable candidates for epilepsy surgery and consideration of the timing of surgery are an important role of pediatrician in surgical treatment of epileptic children. To discuss the timing of surgery, we analyzed clinical courses of 126 patients with TLE and 33 patients with FLE who underwent epilepsy surgery. In many of them seizures continued without remission before surgery. Surgery might have been considered earlier in these cases. Thirty-five (27.8%) of 126 patients with TLE and 10 (30.3%) of 33 patients with FLE had seizure remission before surgery. In TLE, seizure remission was rare in the patients who had convulsive seizures at the onset. In conclusion, the timing of surgery should be determined on individual basis in cases with more than one remission. If deletorious effects of seizures on patient's biological and psychosocial state are evident, surgery should be considered earlier.
National Epilepsy Center, Shizuoka Higashi Hospital, Shizuoka.
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Shimomura
D000293:Adolescent; D001519:Behavior; D002648:Child; D002675:Child, Preschool; D017034:Epilepsy, Frontal Lobe / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics; D010819:Physician's Role; D012074:Remission Induction