PMID: 15331969Aug 28, 2004Paper

Children with drug-resistant partial epilepsy: criteria for the identification of surgical candidates

Revue neurologique
E Hirsch, Alexis Arzimanoglou

Abstract

The majority of candidates for epilepsy surgery, in both children and adults, belong to the syndromic category of partial epilepsies. However, particularly in children, the clinical expression of epilepsy may sometimes be misleading, as paroxysmal events may present as generalized seizures although having a focal onset. The spectrum of surgical possibilities for early-onset epilepsy has tended to widen rapidly and to include not only other focal epilepsies but also more difficult types. This is because developmental lesions that are the major cause of infantile epilepsy are often poorly localized, involve extensive brain areas and require extensive operations (e.g. hemispherotomy). Surgery is also used for progressive conditions such as Rasmussen's encephalitis or Sturge-Weber syndrome. Some forms of generalized symptomatic epilepsy may also benefit from palliative surgical procedures (callosotomy in cases with repetitive drop attacks often as a manifestation of a Lennox-Gastaut syndrome). The timing of surgery partly depends on the probable effectiveness of the operation available for each particular patient. Candidates for epilepsy surgery must be identified early in the process of the disease, thus increasing the chances for...Continue Reading

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