Epilepsy surgery in a pediatric population: a retrospective study of 129 children from a tertiary care hospital in a developing country along with assessment of quality of life.
OBJECTIVE
To assess the outcome of a pediatric population operated for drug-resistant epilepsy from a large tertiary care center in India.


METHODS
Retrospectively: quality of life (QOL); prospectively: preoperative assessment included interictal EEG, MRI (as per epilepsy protocol), video-EEG. Ictal SPECT (with subtraction) and PET were performed when required. QOL scores were assessed using the HASS or SSQ for seizure severity, Quality of Life in Childhood Epilepsy (QOLCE) for QOL, and Child Behavior Check List (CBCL) for behavior.


RESULTS
142 were operated from January 2000 to June 2011 by the senior author. 118 patients with at least 1 year of follow-up were included in the study. Mean age at surgery was 9.8 ± 4.3 years. In addition, 40 patients underwent QOL assessment prospectively both before and after surgery. Mean duration of epilepsy was 5.3 ± 3.3 years. A class I outcome (Engel's) was seen in 79.5% patients, class II in 8.6%, class III in 10.7%, and class IV in 1 patient. As per surgical procedures, class I outcome in patients who underwent temporal resection, hemispherotomy and extratemporal resection was 76, 87 and 72%, respectively. QOL scores correlated with duration of seizures, epileptic encephalopathy and outcome of surgery, but not with side of surgery, age and sex.


CONCLUSIONS
This study, the largest reported from India, has demonstrated satisfactory results for epilepsy surgery in children.
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Amit
A
Dagar
P Sarat
PS
Chandra
Kapil
K
Chaudhary
Chauhan
C
Avnish
C S
CS
Bal
Shailesh
S
Gaikwad
Ajay
A
Garg
Chitra
C
Sarkar
A
A
Srivastava
M V
MV
Padma
Diwedi
D
Rekha
Sheffali
S
Gulati
Vinod
V
Paul
K
K
Prasad
M B
MB
Singh
Manjari
M
Tripathi
D000293:Adolescent; D002648:Child; D003906:Developing Countries; D004831:Epilepsies, Myoclonic / Q000601:surgery; D004828:Epilepsies, Partial / Q000601:surgery; D004827:Epilepsy / Q000601:surgery*; D004829:Epilepsy, Generalized / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D038421:Hemispherectomy; D006801:Humans; D007194:India; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000601:surgery; D016896:Treatment Outcome