title: Seizure outcomes in children with epilepsy after resective brain surgery.
abstract: OBJECTIVE
  To assess the role of resective brain surgery in childhood epilepsy.
  
  
  METHODS
  We retrospectively analysed the seizure outcomes in 55 children with epilepsy who had resective brain surgery between 1997 and 2012, at our centre. The children were 1.5-18 years at the time of surgery; their seizure onset was between 0.2 andto 15 years of age. 48 had refractory epilepsy. One child died of tumour progression. Follow-up duration in the survivors ranged from 2 to -16 years (mean: 9).Presurgical evaluation included clinical profiles, non-invasive V-EEG monitoring, neuroimaging with MRIs in all; SPECT and PET in selected patients. 54 had intraoperative ECoG.
  
  
  RESULTS
  An Engel Class 1 outcome was seen in 78% of the cohort, with 67% being off all AEDs at the most recent follow-up. Children with tumours constituted the majority (56%), with 87% of this group showing a Class 1 outcome and 84% being off AEDs. Children with cortical dysplasia had a Class 1 outcome in 56%.
  
  
  CONCLUSIONS
  Resective brain surgery is an efficacious option in some children with epilepsy. We found ECoG useful to tailor the cortical resection and in our opinion ECoG contributed to the good seizure outcomes.
authors.affiliation: Children's Neuroscience Service, Department of Neurology, Princess Margaret Hospital for Children, Perth, Australia. Electronic address: lakshmi.nagarajan@health.wa.gov.au.
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Nagarajan
authors.affiliation: Children's Neuroscience Service, Department of Neurology, Princess Margaret Hospital for Children, Perth, Australia. Electronic address: leema@cygnus.uwa.edu.au.
authors.forename: Michael
authors.initials: M
authors.lastname: Lee
authors.affiliation: Children's Neuroscience Service, Department of Neurology, Princess Margaret Hospital for Children, Perth, Australia. Electronic address: linda.palumbo@health.wa.gov.au.
authors.forename: Linda
authors.initials: L
authors.lastname: Palumbo
authors.affiliation: Children's Neuroscience Service, Department of Neurology, Princess Margaret Hospital for Children, Perth, Australia. Electronic address: sharon.lee@health.wa.gov.au.
authors.forename: Sharon
authors.initials: S
authors.lastname: Lee
authors.affiliation: Children's Neuroscience Service, Department of Neurology, Princess Margaret Hospital for Children, Perth, Australia. Electronic address: snehal.shah@health.wa.gov.au.
authors.forename: Snehal
authors.initials: S
authors.lastname: Shah
authors.affiliation: Children's Neuroscience Service, Department of Neurology, Princess Margaret Hospital for Children, Perth, Australia. Electronic address: peter.walsh@health.wa.gov.au.
authors.forename: Peter
authors.initials: P
authors.lastname: Walsh
authors.affiliation: Children's Neuroscience Service, Department of Neurology, Princess Margaret Hospital for Children, Perth, Australia. Electronic address: patricia.cannell@health.wa.gov.au.
authors.forename: Patricia
authors.initials: P
authors.lastname: Cannell
authors.affiliation: Children's Neuroscience Service, Department of Neurology, Princess Margaret Hospital for Children, Perth, Australia. Electronic address: soumya.ghosh@health.wa.gov.au.
authors.forename: Soumya
authors.initials: S
authors.lastname: Ghosh
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging / Q000379:methods; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology* / Q000517:prevention & control*; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
keywords: AED withdrawal; Brain tumours; Children; ECoG; Epilepsy surgery; Refractory epilepsy