title: Seizure control following palliative resective surgery for intractable epilepsy-a pilot study.
abstract: BACKGROUND
  Patients with intractable epilepsy who have bilateral epileptic foci may not qualify for curative epilepsy surgery. In some cases palliative resection may be undertaken with a goal to decrease seizure frequency and improve quality of life. Here we present data on the outcome of palliative epilepsy surgery in children.
  
  
  METHODS
  We reviewed medical charts of children who underwent palliative resection for intractable epilepsy during the years 1999-2013 at Children's Hospital of Michigan. The palliative intent of resection was declared preoperatively. Outcome was assessed in terms of seizure reduction.
  
  
  RESULTS
  There were 18 patients (11 males, median age of surgery was 3.5 years [range 0.5-16 years]). The median duration of follow-up after surgery was 12.5 months (range 6-60 months). Hemispherectomy was the most commonly performed palliative resection (nine patients), followed by lobectomy (six patients), multilobar resection (one patient), and tuberectomy (two patients). Reduction in seizure frequency was observed in 11 patients, with eight patients achieving seizure freedom on antiepileptic drugs and three with >50% reduction in seizure frequency. Transient improvement in seizure frequency occurred in two patients, whereas there was no benefit in five patients.
  
  
  CONCLUSIONS
  Beneficial effects of epilepsy surgery may be realized in carefully selected situations wherein the most epileptogenic focus is resected to reduce seizure burden and improve quality of life.
authors.affiliation: Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, Michigan. Electronic address: milyas@dmc.org.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ilyas
authors.affiliation: Carmen and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, Michigan.
authors.forename: Lalitha
authors.initials: L
authors.lastname: Sivaswamy
authors.affiliation: Children's Hospital of Michigan, Detroit, Michigan.
authors.forename: Eishi
authors.initials: E
authors.lastname: Asano
authors.affiliation: Carmen and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, Michigan.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sood
authors.affiliation: Carmen and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Children's Research Center of Michigan, Detroit, Michigan.
authors.forename: Marwan
authors.initials: M
authors.lastname: Zidan
authors.affiliation: Carmen and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, Michigan.
authors.forename: Harry
authors.initials: H
authors.lastname: Chugani
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019635:Neurosurgical Procedures; D010166:Palliative Care; D010865:Pilot Projects; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: epilepsy surgery; intractable epilepsy; palliative resection; quality of life