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Updated: Aug 18, 2026

Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
Published on: September 20, 2024
Epilepsy surgery does not harm motor performance of children and adolescents
R van Empelen1, A Jennekens-Schinkel, J W Gorter
1Department of Paediatric Physical Therapy and Exercise Physiology, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, The Netherlands. R.vanEmpelen@wkz.azu.nl.
Insights
Epilepsy surgery significantly reduces seizures in children. Motor performance and daily activities show improvement, particularly in those with spasticity, indicating surgery is safe for motor function.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Developmental Pediatrics
Background:
- Pharmacologically intractable epilepsy affects children's motor skills and daily life.
- Spasticity of cerebral origin complicates epilepsy management and functional outcomes.
- Assessing the dual impact of epilepsy surgery on seizure control and motor function is crucial.
Purpose of the Study:
- To evaluate the effects of epilepsy surgery on motor performance in children with and without spasticity.
- To assess the impact of surgery on activities of daily life (ADL) and caregiver assistance.
- To determine if epilepsy surgery negatively affects motor function in pediatric patients.
Main Methods:
- Retrospective analysis of 37 children undergoing epilepsy surgery (1996-2001).
- Utilized Engel's classification for seizure outcome, M-ABC and GMFM-88 for motor function, and PEDI for ADL and caregiver assistance.
- Follow-up assessments conducted at 6 months, 1 year, and 2 years post-surgery.
Main Results:
- 74% of children achieved Engel class 1 seizure outcome 24 months post-surgery.
- Statistically significant improvements in motor performance scores (M-ABC, GMFM) were observed (P < 0.05).
- Children with spasticity showed significant improvements in ADL and caregiver assistance (PEDI) (P < 0.05).
Conclusions:
- Epilepsy surgery is effective in reducing seizures in children.
- Surgery does not adversely affect motor performance in children with or without spasticity.
- Functional gains in daily activities and caregiver support are notable, especially in children with spasticity.
Abstract:
The impact of epilepsy surgery on motor performance, activities of daily life (ADL) and caregiver assistance was assessed in 37 children (age range 0.1-15.4 years) with pharmacologically untreatable epilepsy, 17 of whom were also diagnosed as having spasticity of cerebral origin. All patients underwent epilepsy surgery between 1996 and 2001 at the Wilhelmina University Children's Hospital and were assessed using a standard protocol at fixed intervals: before surgery and 6 months, 1 year and 2 years after surgery. The type of surgery was hemispherectomy (n = 14) and temporal (n = 14), frontal (n = 4), parietal (n = 2) and central (n = 2) resection. One child underwent callosotomy. Engel's classification was used to determine seizure outcome. Impairments were measured in terms of muscle strength, range of motion and muscle tone. Motor performance of infants and children without spasticity was measured using the Movement Assessment Battery for Children (M-ABC). The Gross Motor Function Measure (GMFM-88) was used in children with spasticity, the severity of motor disability in this group being determined by means of the Gross Motor Function Classification System (GMFCS). Daily activities and caregiver's assistance were measured in all children using the Pediatric Evaluation of Disability Inventory (PEDI). Twenty-four months after surgery 74% of the children could be classified as Engel class 1, indicating a significant seizure reduction. Impairments revealed some decrease in muscle strength and range of motion in the group with spasticity. Scores improved statistically significantly at group level on M-ABC and GMFM (P < 0.05). Improvement in activities of daily life and caregiver's assistance could not be measured in children without spasticity because of the ceiling effect of the PEDI, but children with spasticity improved significantly with respect to these parameters (PEDI) (P < 0.05). Hence, epilepsy surgery does not harm motor performance in children with or without spasticity.
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