Approach to pediatric epilepsy surgery: State of the art, Part II: Approach to specific epilepsy syndromes and etiologies.

Journal Article (Review)

The second of this 2-part review depicts the specific approach to the common causes of pediatric refractory epilepsy amenable to surgery. These include tumors, malformations due to abnormal cortical development, vascular abnormalities and certain epileptic syndromes. Seizure freedom rates are high (usually 60-80%) following tailored focal resection, lesionectomy, and hemispherectomy. However, in patients in whom the epileptogenic zone overlaps with unresectable eloquent cortex, and in certain epileptic syndromes, seizure freedom may not be achievable. In such cases, palliative procedures such as callosotomy, multiple subpial transections and vagus nerve stimulation can achieve reduction in seizure severity but rarely seizure freedom. Integration of the new imaging techniques and the concepts of neuronal plasticity, the epileptogenic lesion, the ictal onset, symptomatogenic, irritative, and epileptogenic zones is an expanding and dynamic process that will allow us, in the future, to better decide on the surgical approach of choice and its timing.

Full Text

Duke Authors

Cited Authors

  • Obeid, M; Wyllie, E; Rahi, AC; Mikati, MA

Published Date

  • March 2009

Published In

Volume / Issue

  • 13 / 2

Start / End Page

  • 115 - 127

PubMed ID

  • 18590975

Electronic International Standard Serial Number (EISSN)

  • 1532-2130

Digital Object Identifier (DOI)

  • 10.1016/j.ejpn.2008.05.003

Language

  • eng

Conference Location

  • England