title: Seizure outcomes of lesionectomy in pediatric lesional epilepsy with brain tumor -- single institute experience.
abstract: OBJECTIVE
  To determine the clinical characteristics, surgical strategy, and outcome in pediatric lesional epilepsy patients younger than 5years of age undergoing surgery in a single institute.
  
  
  METHODS
  Retrospective data were collected and analyzed on patients younger than 5years of age who underwent lesionectomy for lesional epilepsy at single institute from January 2001 to August 2010. Fourteen pediatric lesional epilepsy patients were enrolled in this study. Engel classification was used to classify seizure outcome.
  
  
  RESULTS
  Median preoperative seizure period was 1month (range, 1-21). Median post-operative follow up period was 35months (range 13-84). Ten patients who underwent gross total resection of tumor showed Engel class Ia seizure outcome without any antiepileptic drug (AED). Subtotal resection was performed in four patients to avoid eloquent area injury. Two of these four patients with subtotal removal became seizure-free (Engel class Ia) without AED, while two were in Engel class Ib with AED medication. There was no significant surgical morbidity or mortality.
  
  
  CONCLUSIONS
  Lesionectomy in children younger than 5years of age is relatively safe and effective in controlling seizures. Short preoperative seizure periods and total removal of tumor might be associated with good outcome. Therefore, early and complete lesionectomy alone may help allow for seizure freedom and optimal brain development in pediatric patients.
authors.affiliation: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Kyung Il
authors.initials: KI
authors.lastname: Jo
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Seung-Chyul
authors.initials: SC
authors.lastname: Hong
mesh_terms: D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000150:complications / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Lesional epilepsy; Lesionectomy; Pediatric; Surgery