Surgical Treatments of the Pediatric Intractable Epilepsy: A Single Center Experience.
- Author:
Deok Soo KIM
1
;
Tae Sung KO
;
Jung Kyo LEE
Author Information
1. Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Pediatric intractable epilepsy;
Surgical treatments;
Surgical outcome
- MeSH:
Brain Neoplasms;
Child;
Classification;
Epilepsy*;
Follow-Up Studies;
Gliosis;
Humans;
Hydrocephalus;
Malformations of Cortical Development;
Paresis;
Radiosurgery;
Seizures;
Subdural Effusion;
Visual Fields
- From:Journal of Korean Epilepsy Society
2005;9(1):72-79
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study evaluates and compares the surgical outcomes of pediatric intractable epilepsy from various surgical modalities. METHODS: Among the patients who underwent epileptic surgery from March 1996 to February 2001, only the children, who had at least one year follow-up, were included in this study. The mean age with first seizure attacks was 3.5 years. The interval between first seizure attacks and surgical treatment was 4.8 years on average, and the mean age at surgical management was 7.4 years. The possible etiology was observed in 75.4% of total patients. Brain tumor and cortical dysplasia were main causes. The surgical treatment was done with various modalities, including resective surgeries (49.2%), corpus callosotomy of disconnection methods (41.5%), combined surgeries (7.7%), and gamma knife radiosurgery (one case). RESULTS: Surgical outcomes were evaluated based on the Engel's classification. After resective surgery, 90.6% of the patients showed class I. The majority of corpus callosotomy (59.3%) had class III. The outcomes after combined surgeries ranged from class I to III. The result of gamma knife radiosurgery was class III. The pathologic findings from resected tissue showed cortical dysplasia, tumor, nonspecific gliosis, etc. The complications after surgery were transient or permanent hemiparesis, visual field defect, hydrocephalus, subdural effusion, etc. CONCLUSION: We performed the various surgical methods in children with medically intractable epilepsy and obtained different results by surgical modalities. The surgical outcome will be improved if there is an appropriate selection among surgical modalities through the various preoperative assessments.
