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Epilepsy Surgery in Children: Why, When and How?

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Abstract

Epilepsy surgery is safe and effective treatment in children who fail to respond to antiepileptic medications. After failure of two appropriate antiepileptic medications, chances that the child will become seizure free with more or different medications is <5 %, and she should be diagnosed with “refractory epilepsy”. A consideration for surgical candidacy should be given to all children who fulfill the definition of refractory epilepsy. In appropriately selected children, epilepsy surgery offers a high chance of seizure freedom without incurring any new post-operative neurological deficits. No age is bar to epilepsy surgery. Even infants can safely have epilepsy surgery if they are surgical candidates. For most children, who are surgical candidates, a good history and physical examination, video EEG evaluation, and a high quality brain MRI are sufficient to make surgical decision. These tools are increasingly available all over the world. Better education of families, Pediatricians, Pediatric Neurologists and community care-givers is necessary to salvage children early from mortality and morbidity of untreated, sometimes life long, epilepsy.

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Conflict of Interest

Dr. Gupta has research grant from Tuberous Sclerosis Alliance. He is on the editorial board of Pediatric Neurology and Epileptic Disorders. Dr. Gupta is on the professional advisory boards of Tuberous Sclerosis Alliance with no financial support. Dr. Gupta has done teaching, speaking and advisory/consultative work for Lundbeck Inc and Questcor Inc.

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  1. Department of Pediatric Epilepsy/Epilepsy Center-S51, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Ajay Gupta

  2. Pediatric Epilepsy/Department of Neurology, Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Ajay Gupta

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  1. Ajay Gupta
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Correspondence to Ajay Gupta.

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Gupta, A. Epilepsy Surgery in Children: Why, When and How?. Indian J Pediatr 81, 1081–1088 (2014). https://doi.org/10.1007/s12098-014-1541-1

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  • DOI: https://doi.org/10.1007/s12098-014-1541-1

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