title: Epilepsy surgery outcomes: quality of life and seizure control.
abstract: A consecutive, retrospective analysis of seizure control and quality of life was performed among 83 pediatric patients undergoing epilepsy surgery at Children's Hospital of Wisconsin. Seizure outcomes were generally favorable, with 68.7% class I outcomes; class II, 12%; and class III, 19.3%. Seizure freedom was highest among temporal lobectomies (84.2%) and hemispherectomies (76.2%). Outcomes among hemispherectomies were substantially superior to those of multilobar resections. Cortical dysplasia was associated with lower seizure freedom, at 57.5%. Among age groups, seizure-free outcomes in infants were lowest, at 50%. The lower infant seizure-free rate was likely attributable to frequency of multilobar resections and type of pathology (cortical dysplasia). Quality-of-life measures generally paralleled seizure outcomes. These results indicate that epilepsy surgery in children with intractable epilepsy can result in significant improvements in seizure control, quality of life, and development. Anticipated type of surgery, presumed location of epileptogenic site, absence of a defined lesion on magnetic resonance imaging scan of the brain, and patient's age should not prevent surgical evaluations of children with intractable epilepsy.
authors.affiliation: Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. mzupanc@mcw.edu
authors.forename: Mary L
authors.initials: ML
authors.lastname: Zupanc
authors.forename: Elliane J dos Santos
authors.initials: EJ
authors.lastname: Rubio
authors.forename: Rhonda R
authors.initials: RR
authors.lastname: Werner
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Schwabe
authors.forename: Wade M
authors.initials: WM
authors.lastname: Mueller
authors.forename: Sean M
authors.initials: SM
authors.lastname: Lew
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Marcuccilli
authors.forename: Sunila E
authors.initials: SE
authors.lastname: O'Connor
authors.forename: Maria S
authors.initials: MS
authors.lastname: Chico
authors.forename: Kathy A
authors.initials: KA
authors.lastname: Eggener
authors.forename: Kurt E
authors.initials: KE
authors.lastname: Hecox
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D054220:Malformations of Cortical Development / Q000150:complications; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods; D011788:Quality of Life; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult