Surgery May Benefit Some Epileptic Children

September 15, 2008

Up to 30 percent of epileptic children have medically refractory epilepsy and may benefit from surgery, according to a review published in the September issue of Neurosurgical Focus.

MONDAY, Sept. 15 (HealthDay News) -- Up to 30 percent of epileptic children have medically refractory epilepsy and may benefit from surgery, according to a review published in the September issue of Neurosurgical Focus.

In their review, Cristina Go, M.D., and O. Carter Snead III, M.D., from the Hospital for Sick Children in Toronto, Ontario, Canada, note that medically refractory epilepsy is defined as inadequate seizure control despite appropriate medical therapy with at least two anti-epileptic drugs at maximal tolerated doses for 18 to 24 months, or adequate seizure control but with unacceptable drug-related side effects.

For these children, either palliative or curative surgery may be an option, the review indicates. Presurgical evaluation for potential epilepsy candidates may include a history and physical; scalp electroencephalography; neuroimaging procedures such as structural neuroimaging by MRI, magnetoencephalography, and positron emission tomography; lateralization of language function; neuropsychological testing; Wada testing; and intracranial electroencephalography.

"The treatment of children with medically intractable epilepsy is both challenging and rewarding," Go and Snead conclude. "Surgery has the potential of altering the natural history of epilepsy by improving or eliminating seizures in carefully selected patients."

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