Pediatric Resective Epilepsy Surgery [Neurosurgery Wiki]

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====== Pediatric Resective Epilepsy Surgery ======

===== Outcome =====

[[Pediatric Resective Epilepsy Surgery Outcome]].


===== Case series =====
Parker et al. performed a [[retrospective]] analysis of 376 pediatric patients who underwent [[resective epilepsy surgery]] between 2007 and 2016 in [[Stanford]] using the Truven MarketScan database. Filled [[Anticonvulsant]]  prescriptions during the pre-and [[postoperative]] periods were compared. [[Univariate]] and [[multivariate]] analyses identified factors associated with achieving stable discontinuation of or reduction in the number of [[anticonvulsant]]s. Health care utilization and costs were systematically compared.

One hundred seventy-one patients (45.5%) achieved a >90-day ASD-free period after surgery, and 84 (22.3%) additional patients achieved a stable reduction in the number of ASDs. Achieving ASD freedom was more common in patients undergoing total hemispherectomy (n = 21, p = .002), and less common in patients with tuberous sclerosis (p = .003). A higher number of preoperative ASDs was associated with a greater likelihood of achieving ASD reduction postoperatively (hazard ratio [HR]: 1.85, 95% confidence interval [CI]: 1.50-2.28), but was not associated with a significant difference in the likelihood of achieving ASD freedom (0.83, 95% CI: 0.49-1.39). Achieving an ASD-free period was associated with fewer hospital readmissions within the first year after surgery.

Patterns of [[anticonvulsant]] use and discontinuation after [[pediatric epilepsy surgery]] provide an unbiased surgical outcome endpoint extractable from administrative databases, where changes in seizure frequency are not captured. This [[quantitative]] measure can augment traditional surgical [[outcome]] [[scale]]s, incorporating a significant clinical parameter associated with improved [[quality of life]]
((Parker JJ, Zhang Y, Fatemi P, Halpern CH, Porter BE, Grant GA. Antiseizure medication use and medical resource utilization after resective [[epilepsy surgery]] in [[child]]ren in the [[United States]]: A contemporary nationwide cross-sectional cohort analysis. Epilepsia. 2022 Feb 25. doi: 10.1111/epi.17180. Epub ahead of print. PMID: 35213744.)).