Pediatric Resective Epilepsy Surgery Outcome

Findings showed favorable long-term seizure outcomes in children who underwent epilepsy surgery. The results are encouraging for developing centers with limited resources to establish pediatric epilepsy programs 1).


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 scales, incorporating a significant clinical parameter associated with improved quality of life 2).


The results of resective epilepsy surgery in a cohort are very edifying, and it is the impression that this treatment option is underused in Norway 3).


Children with drug-resistant epilepsy (DRE). reported improvement in anxiety and depression, irrespective of whether they achieved seizure control, across the 2 years following surgery. In contrast, children with DRE who did not undergo surgery, but achieved seizure freedom, reported worsening of depressive symptoms, which may indicate difficulty adjusting to life without seizures and highlight the potential need for ongoing medical and psychosocial follow-up and support 4).


1)
Günbey C, Bilginer B, Oğuz KK, Söylemezoğlu F, Ergün EL, Akalan N, Topçu M, Turanlı G, Yalnızoğlu D. Lesional resective epilepsy surgery in childhood: Comparison of two decades and long-term seizure outcome from a single center. Epilepsy Res. 2022 Feb 8;181:106882. doi: 10.1016/j.eplepsyres.2022.106882. Epub ahead of print. PMID: 35168000.
2)
Parker JJ, Zhang Y, Fatemi P, Halpern CH, Porter BE, Grant GA. Antiseizure medication use and medical resource utilization after resective epilepsy surgery in children 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.
3)
Aaberg KM, Eriksson AS, Ramm-Pettersen J, Nakken KO. Long-term outcome of resective epilepsy surgery in Norwegian children. Acta Paediatr. 2012 Dec;101(12):e557-60. doi: 10.1111/j.1651-2227.2012.02834.x. Epub 2012 Sep 17. PMID: 22924953.
4)
Phillips NL, Widjaja E, Speechley K, Ferro M, Connolly M, Major P, Gallagher A, Ramachandrannair R, Almubarak S, Hasal S, Andrade A, Xu Q, Leung E, Snead OC 3rd, Smith ML. Longitudinal changes in emotional functioning following pediatric resective epilepsy surgery: 2-Year follow-up. Epilepsy Behav. 2021 Jan;114(Pt A):107585. doi: 10.1016/j.yebeh.2020.107585. Epub 2020 Dec 1. PMID: 33272893.
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