Child's Nervous System

, Volume 16, Issue 5, pp 278–285

Pediatric intractable epilepsy: the role of presurgical evaluation and seizure outcome

Authors

  • Seung-Ki Kim
    • Division of Pediatric Neurosurgery and Clinical Research Institute, Seoul National University Hospital and Neuroscience Research Institute, SNUMRC, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
  • Kyu-Chang Wang
    • Division of Pediatric Neurosurgery and Clinical Research Institute, Seoul National University Hospital and Neuroscience Research Institute, SNUMRC, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
  • Yong-Seung Hwang
    • Department of Pediatrics, Seoul National University Children’s Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
  • Ki Joong Kim
    • Department of Pediatrics, Seoul National University Children’s Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
  • I.-O. Kim
    • Division of Pediatric Radiology, Seoul National University Children’s Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
  • Dong Soo Lee
    • Departments of Nuclear Medicine and Internal Medicine, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
  • Yungnahn Yi
    • Neural Systems Research, 61-3 Yoido-dong, Yungdengpo-gu, Seoul 150-010, Korea
  • Byung-Kyu Cho
    • Division of Pediatric Neurosurgery and Clinical Research Institute, Seoul National University Hospital and Neuroscience Research Institute, SNUMRC, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
Original Paper

DOI: 10.1007/s003810050514

Cite this article as:
Kim, S., Wang, K., Hwang, Y. et al. Child's Nerv Syst (2000) 16: 278. doi:10.1007/s003810050514

Abstract 

Surgical experience with long-term follow-up is limited in childhood intractable epilepsy, compared with adult epilepsy. To assess the role of each presurgical evaluation modality and to identify prognostic factors for favorable seizure control after epilepsy surgery, 38 children with intractable epilepsy who underwent surgery were retrospectively reviewed. Among the available preoperative evaluation modalities, PET and neuropsychological testing showed the highest rates of positive results, whereas MRI was the most concordant with EEG findings. During a follow-up period of at least 12 months, 26 of the 38 patients showed favorable seizure control (Engel classifications I and II). The best seizure control was achieved in patients with a temporal resection and discrete lesion on magnetic resonance imaging. In spite of the invasive study, the less satisfactory results followed an extratemporal resection. We conclude that epilepsy surgery benefits children with intractable epilepsy and that the role of invasive study should be re-established according to the area of resection and presence of discrete lesion on MRI.

Keywords Intractable epilepsyEpilepsy surgeryOutcomeChildren

Copyright information

© Springer-Verlag Berlin Heidelberg 2000