[Surgical indications in pediatric epilepsy]

With the goal of presenting follow-up data from patients seen at the Refractory Epilepsy out-patient clinic of the Hospital de Clínicas de Porto Alegre (HCPA), Brazil, we reviewed the literature on childhood and adolescent epilepsy and epileptic syndromes with indication for surgical treatment. The International League Against Epilepsy's Subcommission for Pediatric Epilepsy Surgery recommends surgical evaluation for cortical dysplasia, tuberous sclerosis complex, polymicrogyria, hypothalamic hamartoma, hemispheric syndromes, Sturge-Weber, Rasmussen, Landau-Kleffner and other situations such as tumors or cerebrovascular injury. The Subcommission proposes the creation of referral centers with functional methods of evaluation, structural imaging, and a multidisciplinary team that includes neurologists, neurosurgeons, neurophysiologists, neuropediatricians, neuropsychologists, pathologists, neuroradiologists and eletroneurophysiology technicians. Creating these centers in developing countries is possible with the cooperation of other regions. Studies have shown improvement in quality of life with less frequent seizures. At HCPA, we provide evaluations and ongoing clinical management of patients with medically refractory epilepsy. Epilepsy surgery is potentially curative and is particularly useful for the pediatric population.