title: Trends in pediatric epilepsy surgery.
abstract: Epilepsy surgery has become an accepted treatment for drug resistant epilepsy in infants and children. It has gained ground in India over the last decade. Certain epilepsy surgically remediable syndromes have been delineated and should be offered surgery earlier rather than later, especially if cognitive/behavioral development is being compromised. Advances in imaging, particularly in MRI has helped identify surgical candidates. Pre-surgical evaluation includes clinical assessment, structural and functional imaging, inter-ictal EEG, simultaneous video -EEG, with analysis of seizure semiology and ictal EEG and other optional investigations like neuropsychology and other newer imaging techniques. If data are concordant resective surgery is offered, keeping in mind preservation of eloquent cortical areas subserving motor, language and visual functions. In case of discordant data or non-lesional MRI, invasive EEG maybe useful using a two-stage approach. With multi-focal / generalized disease, palliative surgery like corpus callosotomy and vagal nerve stimulation maybe useful. A good outcome is seen in about 2/3rd of patients undergoing resective surgery with a low morbidity and mortality. This review outlines important learning aspects of pediatric epilepsy surgery for the general pediatrician.
authors: Department of Pediatric Neurology, New Civil Hospital, Surat, India.
authors: Ritesh
authors: R
authors: Shah
authors: Abhijit
authors: A
authors: Botre
authors: Vrajesh
authors: V
authors: Udani
mesh_terms: D002648:Child; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D019635:Neurosurgical Procedures / Q000379:methods*; D018579:Patient Selection; D010372:Pediatrics / Q000379:methods
references: J Neurosurg Pediatr. 2013 Aug;12(2):134-41
references: 23768202
references: Epilepsy Res. 2009 Nov;87(1):47-53
references: 19734011
references: Neurology. 1997 Jan;48(1):189-96
references: 9008517
references: Ann Neurol. 1990 Apr;27(4):406-13
references: 2353794
references: Ann Neurol. 2007 Oct;62(4):375-81
references: 17253624
references: Dev Med Child Neurol. 1997 Jul;39(7):430-40
references: 9285433
references: Neurology. 2005 Feb 22;64(4):746-50
references: 15728309
references: Neurosurgery. 2006 Dec;59(6):1203-13; discussion 1213-4
references: 17277683
references: J Neurosurg. 2009 Feb;110(2):332-42
references: 19245287
references: J Neurosurg Pediatr. 2010 Sep;6(3):257-66
references: 20809710
references: Childs Nerv Syst. 2011 Mar;27(3):381-90
references: 20857122
references: Epilepsy Curr. 2013 Sep;13(5):198-204
references: 24348103
references: Ann Neurol. 1998 Nov;44(5):740-8
references: 9818929
references: Pediatr Neurosurg. 2011;47(3):186-93
references: 22213776
references: Brain. 2001 Sep;124(Pt 9):1683-700
references: 11522572
references: Neurology. 2007 Jul 24;69(4):389-97
references: 17646632
references: N Engl J Med. 2000 Feb 3;342(5):314-9
references: 10660394
references: Epilepsia. 2013 May;54(5):840-7
references: 23551133
references: Epilepsia. 2013 Feb;54(2):383-9
references: 23106378
references: Epilepsy Behav. 2011 Mar;20(3):478-83
references: 21296622
references: Epilepsia. 1997 May;38(5):553-60
references: 9184601
references: J Neurosurg Pediatr. 2008 Apr;1(4):277-83
references: 18377302
references: Ann Indian Acad Neurol. 2010 Apr;13(2):87-93
references: 20814490
references: Epilepsia. 2012 Sep;53(9):1577-86
references: 22812675
references: Epilepsy Res. 2008 Dec;82(2-3):133-8
references: 18786810
references: Epilepsia. 2005 Apr;46(4):561-7
references: 15816951
references: N Engl J Med. 2001 Aug 2;345(5):311-8
references: 11484687
references: Acta Neurochir (Wien). 2012 Nov;154(11):2017-28
references: 22941395
references: Neurology. 2013 Jan 15;80(3):253-60
references: 23223541
references: Neurology. 2000 Feb 8;54(3):642-7
references: 10680797
references: Epilepsia. 2006 Jun;47(6):952-9
references: 16822241
references: Epilepsia. 2014 Apr;55(4):507-18
references: 24512473
references: J Child Neurol. 2007 Apr;22(4):479-83
references: 17621534
references: Neurol India. 2011 Jan-Feb;59(1):30-6
references: 21339655
references: Seizure. 2013 Jan;22(1):3-8
references: 23068970
references: J Child Neurol. 2005 May;20(5):429-38
references: 15971355