[Surgical treatment of symptomatic surgery in children using classical techniques versus extended lesion surgery and...

In a series of 2400 children 80% had favourablly responded to medication, 60% are seizure-free and in 20% there was significant improvement in further 20% any medication has failed. 200 children have been operated upon because of epilepsy resistant to pharmacological treatment., in 80 = 3% classical methods of removal of the epileptogenic substrate (lobectomies, hemisphereectomies, topectomies and disconnective techniques) have been applied. In 120 cases verified symptomatic epilepsy associated with the leading symptom of untreatable attacks due to aetiological lesions as benign neoplasms, scars, angiomas, cysts lesionectomies extended by focectomies have been performed (with a seizure result of 77.6%). The pathological substrate of the epileptic excitation area has been localized and tailored by repeated diagnostic associated bioelectrical and neuroradiological procedures (EEG, BEAM, SPECT, NMR) Since at least many years after the operation nearly 2/3 of the patients remain seizure-free our methods have proven themselves as a useful and noninvasive tool for the focus localization. The plasticity of the developing brain has resulted in a very impressively favourable outcome particularly in the seizure-free children as far as it concerns the intellectual level and social validation. On neurological testing there was no deterioration. On psychological and neurolinguistic exploration there was an evident improvement of gnostic orientation and quality of life; speech functions are fairly good for current and fluent communication.