[Indications and outcomes of epilepsy surgery in children].
BACKGROUND
One in every four children who suffer epilepsy will continue to seize despite all the current arsenal of anticonvulsant medications. Epilepsy surgery can be an effective treatment for many cases of pharmaco-resistant epilepsy.


OBJECTIVE
To review some of the most recent data regarding indication and results for epilepsy surgery in children.


METHODS
New analysis of neurophysiological data such as magnetoencephalography, dipole analysis and high frequency oscillations, plus functional neuroimaging and higher resolution MRI, have improved the prompt referral of potential candidates for surgery. An adequate selection of the surgical candidates will be fundamental in obtaining positive outcomes. Children, just like adults, can achieve seizure freedom or more than 90% seizure reduction in 85% of the cases of temporal lobe resections. Extratemporal epilepsy surgery is more challenging, and presents frequently in epilepsy surgery centres specialized in pediatric care.


CONCLUSIONS
It is not mandatory for a patient to have an structural lesion evident on MRI in order to be considered a candidate for epilepsy surgery. In many cases a partial reduction of seizure activity can significantly improve the patient's and family's quality of life, and can have a sinergistic effect with other therapies which were no effective before surgery.
Sell-Marucco
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Departamento de Neurología, Hospital for Sick Children, Toronto, Canadá. naranjosell@yahoo.ca
D002648:Child; D004827:Epilepsy / Q000601:surgery*; D006801:Humans; D018579:Patient Selection; D016896:Treatment Outcome