title: Outcomes of resective surgery in children and adolescents with focal lesional epilepsy: The experience of a tertiary epilepsy center.
abstract: This study aimed to investigate the efficacy of resective surgery in children with focal lesional epilepsy by evaluating the predictive value of pre- and postsurgical factors in terms of seizure freedom.
  
  
  
  This study included 61 children aged between 2 and 18years who were admitted to the pediatric video-EEG unit for presurgical workup. Each patient was evaluated with a detailed history, video-EEG, neuroimaging, and postsurgical outcomes according to Engel classification to predict postsurgical seizure freedom. All the possible factors including history, etiology, presurgical evaluation, surgical procedures, and postsurgical results were analyzed for their predictive value for postoperative seizure freedom.
  
  
  
  Of the 61 patients, 75% were diagnosed as having temporal lobe epilepsy (TLE), and 25% were diagnosed with extra-TLE. Two years after the surgery, 78.6% were seizure-free, of which 89% had TLE, and 50% had extra-TLE (p<0.05). Patients were more likely to have a favorable outcome for seizure freedom if they had rare seizure frequency, focal EEG findings, and focal seizures; had a temporal epileptogenic zone; or had TLE and hippocampal sclerosis. On the other hand, patients were more likely to have unfavorable results for seizure freedom if they had younger age of seizure onset, frequent seizures before the surgery, a frontal or multilobar epileptogenic zone, secondarily generalized seizures, extra-TLE with frontal lobe surgery, or focal cortical dysplasia.
  
  
  
  Resective surgery is one of the most effective treatment methods in children with intractable epilepsy. A history of young age of seizure onset, frequent seizures before surgery, secondarily generalized seizures, a multilobar epileptogenic zone, frontal lobe surgery, and focal cortical dysplasia (FCD) are the most important predictive factors indicating that a patient would continue having seizures after surgery. On the other hand, focal seizure semiologies, temporal lobe localization, and hippocampal sclerosis indicate that a patient would have better results in terms of seizure freedom.
authors: Department of Pediatric Neurology & Epilepsy Center, Gazi University School of Medicine, Ankara, Turkey.
authors: Tugba
authors: T
authors: Hirfanoglu
authors: Department of Pediatric Neurology & Epilepsy Center, Gazi University School of Medicine, Ankara, Turkey.
authors: Ayse
authors: A
authors: Serdaroglu
authors: Department of Neurosurgery, Gazi University School of Medicine, Ankara, Turkey.
authors: Gokhan
authors: G
authors: Kurt
authors: Ankara University School of Medicine, Department of Neurosurgery, Ankara, Turkey.
authors: Atilla
authors: A
authors: Erdem
authors: Department of Neurology & Epilepsy Center, Gazi University School of Medicine, Ankara, Turkey.
authors: Irem
authors: I
authors: Capraz
authors: Department of Neurology & Epilepsy Center, Gazi University School of Medicine, Ankara, Turkey.
authors: Erhan
authors: E
authors: Bilir
authors: Department of Pediatric Neurology & Epilepsy Center, Gazi University School of Medicine, Ankara, Turkey.
authors: Ozge
authors: O
authors: Vural
authors: Department of Radiology, Gazi University School of Medicine, Ankara, Turkey.
authors: Murat
authors: M
authors: Ucar
authors: Department of Radiology, Gazi University School of Medicine, Ankara, Turkey.
authors: Ali Yusuf
authors: AY
authors: Oner
authors: Department of Radiology, Gazi University School of Medicine, Ankara, Turkey.
authors: Baran
authors: B
authors: Onal
authors: Department of Nuclear Medicine, Gazi University School of Medicine, Ankara, Turkey.
authors: Ozgur
authors: O
authors: Akdemir
authors: Department of Nuclear Medicine, Gazi University School of Medicine, Ankara, Turkey.
authors: Ozlem
authors: O
authors: Atay
authors: Department of Pediatric Neurology & Epilepsy Center, Gazi University School of Medicine, Ankara, Turkey.
authors: Ebru
authors: E
authors: Arhan
authors: Department of Pediatric Neurology & Epilepsy Center, Gazi University School of Medicine, Ankara, Turkey.
authors: Kursad
authors: K
authors: Aydin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000150:complications / Q000209:etiology / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D054220:Malformations of Cortical Development / Q000150:complications / Q000601:surgery*; D059906:Neuroimaging; D013702:Temporal Lobe / Q000601:surgery*; D016896:Treatment Outcome
keywords: Children; Epilepsy surgery; Focal lesion; Predictive factors