Surgical treatment of epilepsy. Clinical aspects in children.

Abstract

Neurosurgery, mainly temporal lobectomy, has given substantial relief of serious seizure problems in two-thirds of children with intractable epilepsy. Since the prognoses of children with an intractable epilepsy is poor, surgery should be considered. To prevent sequela of a long standing seizure disorder and side effects of antiepileptic medication as well as the development of mirror foci, surgery should be considered at an early age. The age at which surgery should be undertaken depends upon several factors, for instance: the seizure problem, the EEG findings--are they persistently focal and do they fit with the seizures? Is there a malignant development of the epilepsy and little or no chance of remission? And especially, if there is brain pathology in concordance with the clinical findings and EEG signs, neurosurgery should not be postponed. It is of great advantage for children with an intractable epilepsy to be evaluated at an epilepsy center. Both the children and their parents will profit from the evaluation and information gained as well as education by a multiprofessional team. This will optimise the difficult decision process which may lead to neurosurgery.