Outcome of epilepsy surgery in pediatrics

Abstract

Background : Epilepsy is a brain disorder characterized by recurrent attacks of seizures. A seizure is a sudden change of behavior due to a transient alteration in the electrical pattern of the brain. Since despite appropriate drug treatment, one-third of patients continue to have seizures, other treatment must be considered. Aim : This study aims at emphasizing the importance of epilepsy surgery in pediatrics by assessing surgical outcome as regard seizure freedom and surgical morbidity & mortality at Al-Azhar university hospitals. Patients and methods : Prospective study on 27 pediatric patients diagnosed as drug-resistant epilepsy, with 6 months to 1 year follow-up at least. Group A, 14 cases operated by corpus callosotomy, Group B, 10 cases underwent lesionectomy, and Group C, 3 cases underwent MST. Result : 15 cases become seizure free, and 6 cases have rare disabling seizure. Lesionectomy was better than corpus callosotomy in achieving seizure freedom, In Group A, 4 cases become seizure free in comparison to 9 cases in group B. 11 cases of patients in group A (78.6%) showed increase alertness in comparison to the clinical mentality before surgery. The complications that have occurred were transient and resolved shortly. Conclusion : Epilepsy surgery in childhood is effective & safe and needs must be considered once failed medical treatment to prevent cognitive delay. Even when complete seizure freedom is not achieved, a great decrease in frequency of seizures and number of AEDs is a remarkable result.