RT Book, Section
A1 Sarco, Dean P.
A2 Rudolph, Colin D.
A2 Rudolph, Abraham M.
A2 Lister, George E.
A2 First, Lewis R.
A2 Gershon, Anne A.
SR Print(0)
ID 7058156
T1 Chapter 564. Epilepsy Treatment: Surgery
T2 Rudolph's Pediatrics, 22e
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-149723-7
LK accesspediatrics.mhmedical.com/content.aspx?aid=7058156
RD 2024/04/25
AB Most  of  the  0.5%  to  2%  of  the  population  with  epilepsy  will  achieve  seizure  control  with  antiepileptic  drugs.  However,  approximately  16%  of  children  with  new-onset  epilepsy  may  become  medically  refractory  or  may  have  an  epilepsy  syndrome  for  which  medical  treatment  is  known  to  be  ineffective.1  These  children  should  be  evaluated  at  a  comprehensive  pediatric  epilepsy  surgery  program  to  evaluate  their  candidacy  for  epilepsy  surgery,  because  just  over  half  of  them  may  be  surgical  candidates.  The  evaluation  to  determine  candidacy  requires  accurate  classification  of  a  child’s  seizures  and  epilepsy,  knowledge  of  the  natural  history  of  the  child’s  condition,  detailed  information  about  past  epilepsy  treatments,  and  data  acquisition  to  localize  seizures,  including  video-electroencephalography  (EEG)  monitoring,  functional  nuclear  studies,  and  neuroimaging  data.  Because  many  types  of  infantile  and  early  childhood  seizures  are  difficult  to  classify  and  of  uncertain  prognosis,  pediatric  surgical  experience  is  greatest  in  older  children  and  adolescents  who  have  focal  cerebral  lesions  or  mesial  temporal  sclerosis.  Select  infants  and  younger  children,  however,  may  benefit  from  surgery,  particularly  when  persistent  seizures  may  affect  developmental  progress,  as  in  the  catastrophic  epilepsies.