Outcomes after surgery for focal epilepsy in children.
OBJECTIVE
Surgery is an effective treatment for selected patients with intractable epilepsy. The authors report the outcomes of focal resection in a series of children suffering from intractable focal epilepsy treated at a single institution.


METHODS
The authors retrospectively analyzed a series of 58 consecutive children who underwent surgery between 1998 and 2006 for intractable localized epilepsy at Primary Children's Medical Center. Evaluation for surgery and follow-up was performed by the authors in the combined Pediatric Epilepsy Surgery Clinic.


RESULTS
Preoperative seizure duration ranged from 6 months to 15 years. The cause of epilepsy was mesial temporal sclerosis (MTS) in 16 patients, dual pathology (MTS plus another lesion) in 3 patients, low-grade tumors in 16 patients, cortical dysplasia (CD) in 13 patients, cavernous malformation (CM) in 5 patients, and other conditions in 5 patients. In 33 cases, the lesions were in the temporal lobe, and in 25 cases, the lesions were extratemporal. At last follow-up, 74% (43/58) of all patients were seizure-free; seizure-free rates for specific conditions were 88% (14/16) for MTS, 33% (1/3) for dual pathology, 81% (13/16) for tumor, 62% (8/13) for CD, and 80% (4/5) for CM. Seizure-free rates were 85% (28/33) for temporal locations and 60% (15/25) for extratemporal locations. There were no permanent neurological complications or deaths.


CONCLUSIONS
Surgery for localized epilepsy in carefully selected children has good seizure control rates with minimal complications. Outcomes for patients with resections in temporal locations were better than those for patients with extratemporal resections.
Departments of Neurosurgery and Neurology, Primary Children's Medical Center, University of Utah, Salt Lake City, UT, USA.
Peter
P
Kan
Colin
C
Van Orman
John R W
JR
Kestle
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome