When does childhood epilepsy become intractable? Indications and contraindications for epilepsy surgery in children

Surgery for intractable childhood epilepsy may be of great benefit; however, there is a natural tendency for many children with intractable epilepsy to gradually achieve seizure control over years of follow-up. This evolution is much more likely if intelligence is normal. Progressive deterioration in intelligence, school performance, or behavior may be more important in the decision for early surgery than are the seizures themselves. Indications for epilepsy surgery in infancy are most uncertain. Arguments for and against epilepsy surgery in children are presented.