Surgical treatment in children with intractable epilepsy after viral encephalitis.

Epilepsy Research
Chang LiuLixin Cai

Abstract

To investigate the surgical outcome in children with epilepsy after viral encephalitis (VE), we studied the prognostic factors for surgery and summarized the surgical strategies of children with epilepsy secondary to VE. We retrospectively analyzed 23 surgically treated children with VE. The subjects were divided into two groups according to their surgical outcome. All presurgical evaluation data were collected and analyzed. Among the 23 operated children, the mean age at surgery was 6.1 years. Surgeries were hemispherotomy (n = 12), temporal-parietal-occipital disconnection (n = 4), whole corpus callosotomy (n = 3), lobectomy (n = 3), and vagus nerve stimulation (n = 1). The mean patient follow-up time was 37.2 months, and 13 children had a good outcome (ILAE classification 1-3). Univariate analyses revealed that the latency from infection to the first unprovoked seizure, MRI laterality, concordance of PET and MRI abnormalities, and acute postoperative seizure (APOS) were prognostic factors of seizure outcomes (P < 0.05). No correlation was found between generalized seizures and poor outcome (P = 0.229). We concluded that the children who achieve favorable surgical outcomes are those with longer latency, unilateral abnormaliti...Continue Reading

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