title: Extratemporal resection for childhood epilepsy.
abstract: There have been relatively few studies reporting the safety, efficacy, and outcome in children undergoing extratemporal resection for epilepsy. We reviewed the pediatric cases of extratemporal resection for intractable epilepsy performed by the Comprehensive Epilepsy Program at the University of Alberta Hospitals between 1988-1998. Thirty-five patients were studied, 14 male and 21 female. The age at operation ranged from 6 months to 16 years. The operations included frontal excisions (12), parietal (8), occipital (4), hemispherectomies or multilobar resections (10), and one removal of a hypothalamic hamartoma. The pathology at surgery included patients with focal cortical dysplasia (8), brain tumors (6), neurocutaneous syndrome (7), Rasmussen's encephalitis (2), porencephalic cysts (4), hypothalamic hamartoma (1), and nonspecific gliosis (6). Twenty-four of 35 patients (68.5%) had an Engel Class I outcome after surgery and an additional six patients (11%) had a significant decrease in seizure frequency (Engel Class III). Complications were observed in two patients (5%) and there were no deaths. Extratemporal resection is a safe and effective treatment for children with intractable epilepsy. Overall, 68% of patients were seizure-free after surgery, although outcome may be dependent on site and pathology. A wide range of developmental pathology was observed including focal cortical dysplasia, brain tumors, and lesions with neurocutaneous syndromes. Many families reported improvement in behavior and psychosocial function after surgery.
authors.affiliation: Comprehensive Epilepsy Program, University Of Alberta, Edmonton, Alberta, Canada.
authors.forename: D Barry
authors.initials: DB
authors.lastname: Sinclair
authors.forename: Keith
authors.initials: K
authors.lastname: Aronyk
authors.forename: Thomas
authors.initials: T
authors.lastname: Snyder
authors.forename: John D S
authors.initials: JD
authors.lastname: McKean
authors.forename: Matt
authors.initials: M
authors.lastname: Wheatley
authors.forename: Donald
authors.initials: D
authors.lastname: Gross
authors.forename: Alexander
authors.initials: A
authors.lastname: Bastos
authors.forename: S Nizamuddin
authors.initials: SN
authors.lastname: Ahmed
authors.forename: Chunghai
authors.initials: C
authors.lastname: Hao
authors.forename: William
authors.initials: W
authors.lastname: Colmers
mesh_terms: D000293:Adolescent; D001927:Brain Diseases / Q000601:surgery; D001932:Brain Neoplasms / Q000601:surgery; D002540:Cerebral Cortex / Q000002:abnormalities / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D038421:Hemispherectomy; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000209:etiology; D011612:Psychosurgery / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome