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Current Treatment Options in Neurology
Published in: Current Treatment Options in Neurology 6/2012

01-12-2012 | PEDIATRIC NEUROLOGY (HS SINGER, SECTION EDITOR)

Surgical Approaches to Treating Epilepsy in Children

Authors: Trupti Jadhav, MB BS, DCH, DNB, J. Helen Cross, MB ChB, PhD, FRCP, FRCPCH

Published in: Current Treatment Options in Neurology | Issue 6/2012

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Opinion statement

Surgery for refractory epilepsy in appropriately selected children is effective. The key factors influencing a good outcome are careful selection of candidates, early referral to pediatric epilepsy surgical unit, underlying neuropathology and the completeness of surgical resection of the seizure focus. Although the primary aim of a surgery is seizure freedom, benefits are also seen in cognitive development. Early prompt referral is therefore desired to optimise outcome. Focal resections involving the temporal and frontal lobes are the common resective procedures in children, with cortical malformations the most common underlying pathology. Hemispherectomy or multilobar procedures are more commonly performed in children younger than four years. Seizure free rates reach 60–80 %. The availability of newer techniques for presurgical evaluation, along with invasive intracranial electroencephalographic (EEG) recording, has facilitated surgical consideration. Resective surgery may also be beneficial for children who may appear to have bilateral or generalised clinical or EEG features associated with focal lesions on MRI. Vagal Nerve Stimulation (VNS) and corpus callosotomy are employed for selected candidates not suitable for resective surgery with good results.
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Metadata
Title
Surgical Approaches to Treating Epilepsy in Children
Authors
Trupti Jadhav, MB BS, DCH, DNB
J. Helen Cross, MB ChB, PhD, FRCP, FRCPCH
Publication date
01-12-2012
Publisher
Current Science Inc.
Published in
Current Treatment Options in Neurology / Issue 6/2012
Print ISSN: 1092-8480
Electronic ISSN: 1534-3138
DOI
https://doi.org/10.1007/s11940-012-0203-8

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