Danish experience with paediatric epilepsy surgery

Danish Medical Journal
|December 2, 2015
PubMed

Insights

Epilepsy surgery offers good seizure control for children with intractable epilepsy. Outcomes in Denmark are comparable to international standards, though patient selection criteria have evolved.

Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Epilepsy surgery is a growing treatment for medically intractable epilepsy in children.
  • This study examines the causes and seizure outcomes of pediatric epilepsy surgery in Denmark between 1996 and 2010.

Purpose of the Study:

  • To investigate the aetiology and seizure outcomes of epilepsy surgery in Danish children.
  • To analyze changes in surgical practices and outcomes over time.

Main Methods:

  • Retrospective data collection on magnetic resonance imaging (MRI) diagnoses, surgical procedures, and Engel Classification seizure outcomes.
  • Analysis of changes in surgical approaches and outcomes across three time periods: 1996-2000, 2001-2005, and 2006-2010.

Main Results:

  • 95 children underwent epilepsy surgery, with 63 operations in Denmark and 50 abroad; 14 required reoperation.
  • At a median four-year follow-up, 67% achieved Engel class I (no disabling seizures).
  • Common findings included cortical dysplasia, mesial temporal sclerosis, and tumors. Tumor resections decreased, while frontal lobe resections increased. Later surgeries with normal MRIs showed less favorable outcomes. Complications were rare (3/113 operations).

Conclusions:

  • Most children experience significant seizure reduction after epilepsy surgery.
  • The seizure outcomes for Danish children align with those reported by other international epilepsy surgery centers.
  • Evolving clinical criteria influenced patient selection for epilepsy surgery over the study period.
Abstract

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