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The Indian Journal of Pediatrics

, Volume 82, Issue 3, pp 277–285 | Cite as

Trends in Pediatric Epilepsy Surgery

  • Ritesh Shah
  • Abhijit Botre
  • Vrajesh UdaniEmail author
Review Article

Abstract

Epilepsy surgery has become an accepted treatment for drug resistant epilepsy in infants and children. It has gained ground in India over the last decade. Certain epilepsy surgically remediable syndromes have been delineated and should be offered surgery earlier rather than later, especially if cognitive/behavioral development is being compromised. Advances in imaging, particularly in MRI has helped identify surgical candidates. Pre-surgical evaluation includes clinical assessment, structural and functional imaging, inter-ictal EEG, simultaneous video -EEG, with analysis of seizure semiology and ictal EEG and other optional investigations like neuropsychology and other newer imaging techniques. If data are concordant resective surgery is offered, keeping in mind preservation of eloquent cortical areas subserving motor, language and visual functions. In case of discordant data or non-lesional MRI, invasive EEG maybe useful using a two-stage approach. With multi-focal / generalized disease, palliative surgery like corpus callosotomy and vagal nerve stimulation maybe useful. A good outcome is seen in about 2/3rd of patients undergoing resective surgery with a low morbidity and mortality. This review outlines important learning aspects of pediatric epilepsy surgery for the general pediatrician.

Keywords

Surgery Pediatric Drug-resistant epilepsy 

Notes

Contributions

RS: Prepared the initial draft and helped in adding references to the manuscript; AB: Compiled data from Hinduja Hospital Epilepsy Surgery Programme; VU: Finalized and approved the manuscript, helped with further referencing. VU will act as guarantor for this paper.

Conflict of Interest

None.

Source of Funding

None.

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Copyright information

© Dr. K C Chaudhuri Foundation 2015

Authors and Affiliations

  1. 1.Department of Pediatric Neurology, New Civil HospitalSuratIndia
  2. 2.Section of Child Neurology and Epilepsy, Department of Pediatrics and NeurologyPD Hinduja National HospitalMumbaiIndia

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