[Epilepsy surgery in childhood: theory and practice]

1-1.5% of the Hungarian child population has epilepsy, and around 20% of them produces seizures in spite of modern antiepileptic drugs. A part of the pharmaco-resistant children may benefit from surgical removal of the epileptogenic focus. Presurgical evaluation has been developed a lot since the progress of neuroimaging, video-EEG monitoring, neuropsychology, and neurosurgical techniques in the 1990s. Authors summarize the important steps of presurgical evaluation in epileptic children emphasizing the role of history taking, physical examination, neuroimaging, standard EEG, long term monitoring, and neuropsychology. They describe the surgical treatment of the most important epilepsy syndromes in childhood analyzing the data of 58 epileptic children examined in the Bethesda Children's Hospital and operated in the National Institute of Neurosurgery (Budapest, Hungary). Age of children at surgery was between 16 months and 18 years, dysplasia and benign tumors covered etiology in 59% of the cases. The most frequent intervention was resection; however also some callosotomies and hemispherotomies were completed. Authors emphasize the importance of early surgical intervention of therapy resistant children in order to prevent the deteriorating effects of epilepsy on childhood psychomotor development.