Surgical management of pediatric intractable epilepsy

Objective To investigate the surgical management of pediatric intractable epilepsy.Methods The surgical experience of 142 pediatric patients with intractable epileptic between 2002 and 2007 was reviewed.Resection of epileptogenic foci or lobe,and(or)multiple subpial transaction(MST)was carried out when a focal epileptic discharge was indicated according to preoperative evaluation and electroconicography(EcoG),but multilobar resection with MST and(or)corpus callosotomy was chosen to deal with hemispheric multiple epileptic foci.Results During the follow-up,3 years in average,65 of 142 patients had post-operative outcome of Engel Class I,34 patients had rare seizure(Engel Class Ⅱ),and 25 patients got a decrease in seizure frequency(Engel Class III).Mean full intelligence quotient(FIQ)improved from 65.4 to 80.9,and more IQ improvement in patients with shorter seizure history and drug-resistance time.Temporary complications were observed in 16 patients and there was no death case.Conclusion Good surgical results can be achieved in pediatric patient with intractable epilepsy.Early surgical intervention in intractable pediatric epilepsy provides the good opportunity to control the seizure and prevent the irreversible worse of intelligence and the disability for a life-time.