Epilepsy surgery in children compared to adults
Hila Hindi-Ling1, Svetlana Kipervasser, Miri Y Neufeld
1Department of Statistics and Operational Research, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel.
Insights
Pediatric and adult epilepsy surgery outcomes were compared. While surgical techniques differed by age, overall success rates were similar, with no significant age-related differences in seizure reduction or neurological deficits.
Area of Science:
- Neurosurgery
- Epileptology
- Pediatric Neurology
Background:
- Epilepsy surgery is a critical treatment option for refractory epilepsy.
- Understanding age-specific surgical approaches and outcomes is vital for optimizing patient care.
Purpose of the Study:
- To compare surgical techniques and outcomes in pediatric versus adult epilepsy surgery patients.
- To analyze age-related differences in the frequency of specific surgical procedures and their effectiveness.
Main Methods:
- Retrospective analysis of 186 epilepsy surgery patients (55 children, 131 adults) between 1997-2006.
- Inclusion criteria: >2 years follow-up and video-EEG monitoring.
- Surgical techniques and postoperative seizure reduction (>50% and >90%) were compared between age groups.
Main Results:
- Children underwent more extra-temporal non-lesional resections and hemispherectomies; adults had more temporal lobe resections.
- Over 50% of all patients achieved >90% seizure reduction, with no significant difference between age groups.
- Tumor lesionectomies, particularly in the temporal lobe, showed better outcomes; long-term neurological deficits were rare (1%).
Conclusions:
- Children represented 30% of epilepsy surgery cases.
- Surgical approaches varied significantly by age, but overall outcomes were comparable.
- No age-related disparities in surgical success or long-term neurological deficits were observed.
Aim:
The purpose of this study was to compare the frequency of various surgical techniques and surgical outcome between pediatric and adult populations that underwent epilepsy surgery by the same team.
Methods:
All patients who underwent epilepsy surgery at the Tel Aviv Medical Center between 1997 and 2006 and had been followed up for >2 years were eligible for this study. The majority (90%) of all epilepsy surgeries carried out in Israel were performed in this institution and by a single neurosurgeon. Only patients that underwent video-EEG monitoring as part of the presurgical evaluation were included in the study.
Results:
A total of 186 patients (131 adults and 55 children) underwent epilepsy surgery in our institute during the study period, and follow-up was available for 177 patients (95%). While the adults underwent significantly more temporal lobe resections (51 vs. 20%, p < 0.0001), the children had significantly more extra-temporal non-lesional resections (18 vs. 1%, p < 0.0001) and hemispherectomies (5 vs. 1%, p = 0.002). Over one half (54%) of all the patients had a postoperative reduction in seizures of >90%, and 72% had a reduction of >50%, with no group difference in surgical success. Among the lesionectomies, the outcome was better for tumors, especially those in the temporal lobe. Only 1% of the patients had a long-term neurological deficit.
Conclusions:
Children comprised 30% of the epilepsy surgical cases during the study period. Children underwent more non-lesional resections and hemispherectomies, while adults underwent more temporal lobe resections. There was no age-related difference in surgical outcome.
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:22Epilepsy ll: Types
01:13Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
01:30Electroconvulsive Therapy