Surgery of pediatric patients with intractable epilepsy syndromes

Objective The drug-resistance in some epilepsy syndromes that begin in the childhood are predictable and show the tolerance to epilepsy surgery, and surgery of 27 pediatric patients with intractable epileptic syndromes between 1997-2004 were reviewed. Methods Resection of epileptogenic foci or lobe, and/or multiple subpial transection( MST) was followed when a focal epileptic discharge was indicated according to preoperative evaluation and EcoG, but multilobar resection with MST or/and corpus callosotomy were chosen to deal with hemispheric multiple epileptic foci. Results At follow-up, on average 4.5 years after surgery, fourteen of 27 patients (51.9% ) had an Engel Class I outcome after surgery and an additional eight patients (29. 6% ) had rare seizure (Engel Class II ) , and three patients had a decrease in seizure frequency ( Engel Class III ). Mean IQ improved from 61. 4 to 75. 0, and more IQ improvement followed the patients with shorter seizure history and drug-resistance time. Temporary complications were observed in four patients and there were no death. Conclusion Early surgical intervention in intractable pediatric epilepsy syndromes provides the good opportunity to control the seizure, prevent irreversible impairment of intelligence and avoid a lifetime of disability.