title: Outcomes of epilepsy surgery in childhood-onset epileptic encephalopathy.
abstract: OBJECTIVE
  to evaluate the outcomes and role of epilepsy surgery in children with intractable epileptic encephalopathy (EE).
  
  
  METHODS
  ninety-five children (64 boys, 31 girls) with intractable EE were treated by epilepsy surgery at Severance Children's Hospital from 2003 to 2008. Surgical treatments included lobar resection, hemispherotomy and corpus callosotomy (CC). Seventy-six children were Lennox-Gastaut syndrome (LGS), and 19 had West syndrome.
  
  
  RESULTS
  of the 76 patients with LGS, CC was performed in 37 patients (48.7%), lobar resection in 29 (38.2%) and hemispherotomy in 10 (13.2%). Of the 19 patients with West syndrome, respective surgery was performed in 15 patients (78.9%) and CC in 4 (21.1%). Of the patients receiving respective surgery, Engel's class I outcomes were achieved for 24 of 39 (61.5%) of LGS patients, and for 9 of 15 (60.0%) of West syndrome. Malformations of cortical development were commonly observed, appearing in 73.5% (36/49). In neuropsychiatric tests, 19 of 27 with LGS demonstrated improvement in postoperative cognitive function. More significant intellectual improvement correlated well with shorter epilepsy duration, good seizure outcomes, and decreased number of antiepileptic drugs.
  
  
  CONCLUSIONS
  epilepsy surgery should be considered in treating childhood intractable EE with expectation of improvement of both seizure and cognitive outcomes, even in cases of LGS.
authors.affiliation: Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Republic of Korea.
authors.forename: Yun-Jin
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Pediatric Epilepsy Clinics, Severance Children's Hospital, Brain Research Institute, Yonsei University College of Medicine, Republic of Korea.
authors.forename: Joon Soo
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Pediatric Epilepsy Clinics, Severance Children's Hospital, Brain Research Institute, Yonsei University College of Medicine, Republic of Korea.
authors.forename: Hoon-Chul
authors.initials: HC
authors.lastname: Kang
authors.affiliation: Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Republic of Korea.
authors.forename: Dong-Seok
authors.initials: DS
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Republic of Korea.
authors.forename: Kyu-Won
authors.initials: KW
authors.lastname: Shim
authors.affiliation: Department of Psychiatrics, Severance Hospital, Yonsei University College of Medicine, Republic of Korea.
authors.forename: Soyong
authors.initials: S
authors.lastname: Eom
authors.affiliation: Department of Pediatrics, Pediatric Epilepsy Clinics, Severance Children's Hospital, Brain Research Institute, Yonsei University College of Medicine, Republic of Korea. Electronic address: hdkimmd@yuhs.ac.
authors.forename: Heung Dong
authors.initials: HD
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007361:Intelligence Tests; D065768:Lennox Gastaut Syndrome / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D054220:Malformations of Cortical Development / Q000150:complications / Q000473:pathology; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures; D013036:Spasms, Infantile / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: Child; Cognitive outcome; Epileptic encephalopathy; Seizure outcome; Surgery