title: Surgically amenable epilepsies in children and adolescents: clinical, imaging, electrophysiological, and post-surgical outcome data.
abstract: OBJECTIVE
  A large number of patients with epilepsy in the pediatric population have medically intractable epilepsy. In this age group seizures are usually daily or weekly, and response to antiepileptic therapy is poor, especially for those with neurological abnormalities and symptomatic epilepsies. However, several authors have already demonstrated similarly favorable long-term post-surgical seizure control when comparing pediatric and adult populations. In this article we aim to report the experience of the Ribeirão Preto Epilepsy Surgery Program in pediatric epilepsy surgery.
  
  
  METHODS
  We analyzed 107 patients with medically intractable epilepsy operated on between July 1994 and December 2002, considering age at surgery, seizure type, pathological findings, and seizure outcome. All data were prospectively collected according to protocols previously approved by the institution ethics committee.
  
  
  RESULTS
  We analyzed a total of 115 operations performed in 107 patients. There was no difference in sex distribution. Complex partial seizures occurred in 31.4% of the patients, followed by tonic seizures (25.9%), focal motor seizures (15.4%), and infantile spasms (13.3%). The most common etiologies were cortical developmental abnormalities (25.2%), tumors (16.8%), mesial temporal sclerosis (15.9%), Rasmussen syndrome (6.5%), and tuberous sclerosis (6.5%). Overall post-surgical seizure outcome showed 67.2% of the patients within Engel classes I and II, reaching 75.0% when patients with callosotomies were excluded.
  
  
  CONCLUSIONS
  Post-surgical seizure control in the pediatric population is similar to that in adult patients, despite the fact that epilepsies in this age group are more frequently of extratemporal origin, suggesting that surgery should be considered in children as soon as intractability is determined.
authors.affiliation: Department of Neurology, Ribeirão Preto School of Medicine, University of São Paulo, Campus Universitário, Brazil.
authors.forename: Vera C
authors.initials: VC
authors.lastname: Terra-Bustamante
authors.forename: Regina M F
authors.initials: RM
authors.lastname: Fernandes
authors.forename: Luciana M
authors.initials: LM
authors.lastname: Inuzuka
authors.forename: Tonicarlo R
authors.initials: TR
authors.lastname: Velasco
authors.forename: Veriano
authors.initials: V
authors.lastname: Alexandre
authors.forename: Lauro
authors.initials: L
authors.lastname: Wichert-Ana
authors.forename: Sandra
authors.initials: S
authors.lastname: Funayama
authors.forename: Eliana
authors.initials: E
authors.lastname: Garzon
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Santos
authors.forename: David
authors.initials: D
authors.lastname: Araujo
authors.forename: Roger
authors.initials: R
authors.lastname: Walz
authors.forename: João A
authors.initials: JA
authors.lastname: Assirati
authors.forename: Helio R
authors.initials: HR
authors.lastname: Machado
authors.forename: Américo C
authors.initials: AC
authors.lastname: Sakamoto
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003952:Diagnostic Imaging / Q000379:methods*; D004569:Electroencephalography; D004594:Electrophysiology; D004827:Epilepsy / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009460:Neurologic Examination; D009493:Neurosurgery / Q000379:methods*; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D014741:Video Recording
chemical_list: D000927:Anticonvulsants