Surgical Treatment for Intractable Childhood Epilepsy.
- Author:
Yoon Jung CHO
1
;
Chun Soo KIM
;
Joon Sik KIM
;
Chin Moo KANG
;
Ji Eun KIM
;
Sang Do YI
;
Eun Ik SON
Author Information
1. Department of Pediatrics, Keimyung University, College of Medicine, Taegu, Korea.
- Publication Type:Original Article
- Keywords:
Intractable seizure;
Epilepsy surgery
- MeSH:
Adult;
Electrodes;
Electroencephalography;
Epilepsy*;
Epilepsy, Temporal Lobe;
Hemispherectomy;
Humans;
Neuroimaging;
Neuropsychological Tests;
Parietal Lobe;
Parturition;
Prognosis;
Seizures
- From:Journal of the Korean Pediatric Society
1998;41(11):1565-1574
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: For certain forms of childhood epilepsy that remain uncontrolled despite adequate treatment with standard antiepileptic medication, surgical therapy should be considered as a potential treatment. The prognosis for seizure control after early surgery is favorable and is at least comparable with that of adults. With the exception of the obvious benefit conferred by alleviating seizures at a younger age, early surgery also later improves psychosocial status and adaptive function. This study was performed to evaluate the efficacy of epilepsy surgery. METHODS: We analyzed the results of 28 cases of intractable childhood epilepsy who underwent epilepsy surgery at the epilepsy center of Dongsan Medical Center between February, 1993 and January, 1996. They followed up for at least 15 months after surgery. Seizures began at 14 days to 15 years (mean 6.3 years) after birth and had been refractory to antiepileptic medications. Presurgical evaluations of epilepsy included detailed clinical history, scalp/sphenoidal EEG, Video-EEG monitoring, neuroimaging, neuropsychological test, Wada test and invasive study with subdural electrodes. RESULTS: Temporal lobectomy (with or without corticectomy) was performed in 13 cases, extratemporal lobectomy in 11 cases (frontal lobe n=7, parietal lobe n=2, frontoparietal n=1, parietooccipital n=1), functional hemispherectomy in two cases and corpus callosotomy in two cases. The surgical outcome was better in temporal lobe epilepsy compared with that of extratemporal lobe epilepsy. In temporal lobe epilepsy, seven of 13 cases had class I outcome grade, four cases had class II and the rest had class III and class IV. In extratemporal lobe epilepsy, five of 11 cases had class I outcome and the remainders had class III, IV. CONCLUSION: Our results agree with previous reports that epilepsy surgery can provide relief from intractable seizure in pediatric patients, but more extensive study for the patients' cognitive and behavior status will be necessary.
