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Epilepsy surgery near or in eloquent cortex in children-Practice patterns and recommendations for minimizing and

Prasanna Jayakar1, Anuj Jayakar2, Mark Libenson3

  • 1Department of Neurology and Comprehensive Epilepsy Program, Brain Institute, Nicklaus Children's Hospital, Miami, Florida.

Epilepsia
|July 24, 2018
PubMed

Insights

Pediatric epilepsy surgery centers worldwide show wide variation in defining and resecting epileptogenic zones (EZs) near eloquent cortex (EC). Establishing best practices is crucial to improve seizure control and minimize neurological deficits.

Area of Science:

  • Pediatric Neurosurgery
  • Epileptology
  • Surgical Neurology

Background:

  • Epileptogenic zones (EZs) near or within eloquent cortex (EC) present surgical challenges in pediatric epilepsy.
  • Current surgical resection strategies for these cases lack global standardization.

Purpose of the Study:

  • To investigate worldwide practices in surgical resection strategies for pediatric epilepsy involving EZs near or in EC.
  • To identify variations in diagnostic test utilization and surgical planning.

Main Methods:

  • A global survey was conducted among 40 respondents from 33 pediatric epilepsy surgery centers.
  • The survey focused on diagnostic test weighting, EC definition, and surgical planning for EZs near EC.

Main Results:

  • Significant variability was observed in diagnostic test application and resection strategies for EZs and EC.
  • Practices differ considerably across international pediatric epilepsy surgery centers.

Conclusions:

  • The heterogeneity in surgical approaches may lead to suboptimal seizure outcomes and neurological deficits.
  • There is a critical need for standardized best practices in pediatric epilepsy surgery to improve patient outcomes and reporting consistency.
Abstract

Keywords:
critical cortexdeficit scaleepilepsy surgery strategiesepileptogenic zone

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