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Published on: May 16, 2019
Advances in the diagnosis and treatment of epilepsy
Mandeep S Tamber1, James M Mountz
1Department of Neurosurgery, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Insights
Pediatric epilepsy surgery is safe and effective for properly selected children, even infants. Advanced imaging and surgical techniques are improving outcomes, moving surgery from a last resort to a viable treatment option.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Epileptology
Background:
- Epilepsy is a common and serious childhood brain disorder with significant impacts.
- Historically, epilepsy surgery faced skepticism regarding its efficacy and safety.
- Advancements in diagnostics and surgical techniques are reshaping perceptions of epilepsy surgery.
Purpose of the Study:
- To review the surgical treatment of pediatric epilepsy.
- To discuss patient selection, indications, and outcomes of common surgical procedures.
- To explore the future of surgical interventions for childhood epilepsy.
Main Methods:
- Review of current literature on pediatric epilepsy surgery.
- Emphasis on advanced imaging techniques for patient selection.
- Analysis of indications and outcomes for various surgical procedures.
Main Results:
- Epilepsy surgery can be performed safely in children, including infants.
- Proper patient selection, guided by advanced imaging, is crucial for success.
- Surgical interventions offer excellent outcomes for appropriately selected pediatric epilepsy patients.
Conclusions:
- Epilepsy surgery is a safe and effective option for pediatric patients.
- Refined techniques and imaging have established surgery as a key treatment, not a last resort.
- The future of pediatric epilepsy surgery holds promise for improved patient care.
Abstract:
Epilepsy is the most common serious brain disorder in children, occurring in all parts of the world and within every stratum of the population. Through its effects, it exerts a significant physical, psychological, economic, and social toll on children and their caregivers. Historically, the surgical treatment of epilepsy has been viewed with skepticism with regard to its indications, safety, and therapeutic benefit. However, continued refinements in diagnostic and operative techniques are helping to put to rest the antiquated notion that surgery is a last-resort procedure in the management of pediatric epilepsy. Surgery can be performed safely, even in infants and young children, with excellent patient outcomes in properly selected patients. This review focuses on the surgical treatment of pediatric epilepsy. A brief background discussion of seizures and epilepsy is followed by a substantive discussion regarding the intricacies of selecting patients for epilepsy surgery, emphasizing the important role of advanced imaging techniques in the decision-making process. The indications and outcomes of the most common epilepsy surgical procedures are then reviewed. The article ends with a discussion of the future of epilepsy surgery.
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