Long-term outcomes of epilepsy surgery in school-aged children with partial epilepsy
Shuli Liang1, Shuai Wang, Junchen Zhang
1Capital Epilepsy Therapy Center, Department of Neurosurgery, First Affiliated Hospital of Chinese People's Liberation Army General Hospital, Beijing, China. liangsl_304@sina.com
Insights
Epilepsy surgery in Chinese school-aged children with intractable partial epilepsy shows high seizure freedom rates. Surgical outcomes are comparable to developed countries, highlighting the need for improved surgical candidate criteria.
Area of Science:
- Neurology
- Pediatric Epilepsy Surgery
Background:
- Limited data exists on pediatric epilepsy surgery outcomes in developing countries.
- Understanding surgical outcomes in Chinese school-aged children is crucial for improving care.
Purpose of the Study:
- To compare surgical outcomes of intractable partial epilepsy in Chinese school-aged children with those from developed countries.
- To define surgical candidate criteria for pediatric epilepsy surgery in China.
Main Methods:
- Retrospective analysis of 206 children (aged 6-14) undergoing epilepsy surgery between 2001 and 2007.
- Data collected from four surgical centers in China.
- Evaluation of seizure control, neuroimaging findings, and cognitive/quality of life assessments.
Main Results:
- Postoperative seizure freedom rates were 84.0% at 1 year, 72.3% at 3 years, and 67.5% at 5 years.
- Favorable outcomes were associated with focal MRI abnormalities and shorter seizure history.
- Seizure-free patients with preoperative low intelligence quotients showed significant improvements in cognitive function and quality of life.
Conclusions:
- Epilepsy surgery is effective in Chinese school-aged children with intractable partial epilepsy.
- Surgical outcomes are comparable to those reported in developed nations.
- Refined surgical candidate selection criteria can optimize outcomes and improve quality of life.
Abstract:
The pediatric epileptic spectrum and seizure control in surgical patients have been defined in developed countries. However, corresponding data on school-aged children from developing countries are insufficient. We summarized epileptic surgical data from four centers in China, to compare surgical outcomes of school-aged children with intractable partial epilepsy from China and those from developed countries, and introduce surgical candidate criteria. Data from 206 children (aged 6-14 years) undergoing surgical resection for epilepsy between September 2001 and January 2007 were selected. Postoperative freedom from seizures was achieved in 173 cases (84.0%) at 1 year, 149 (72.3%) at 3 years, and 139 (67.5%) at 5 years. Patients with focal magnetic resonance imaging abnormalities and a short history of seizure were most likely to become seizure-free postoperatively. Those with preoperative low intelligence quotients who became seizure-free postoperatively achieved improvements in full memory quotients, intelligence quotients, and overall quality of life at 2 years. Significant differences were evident in mean changes of full intelligence quotient, full memory quotient, and overall quality of life between patients with preoperative low intelligence quotients who received corpus callosotomies and those with a normal preoperative intelligence quotient, and between seizure-free children and those with continual seizures.
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