Endovascular embolization for medically refractory pediatric epilepsy: a case series

Area of Science:

• Neurology
• Pediatric Neurology
• Interventional Neuroradiology

Background:

• Refractory epilepsy in children poses significant management challenges.
• Endovascular embolization is an emerging minimally invasive option for epilepsy management.
• Traditional surgical interventions may carry high risks for certain pediatric populations.

Purpose of the Study:

• To evaluate the feasibility, safety, and outcomes of endovascular embolization.
• To assess the efficacy in pediatric patients with intractable epilepsy of diverse origins.

Main Methods:

• Retrospective case series of four pediatric patients (ages 2-9) with medically refractory epilepsy.
• Patients underwent staged endovascular embolization between 2022-2024.
• Inclusion criteria: contraindications to surgery, failure of ≥2 anti-seizure medications; outcomes: seizure reduction, functional improvement, complications; follow-up: 10-15 months.

Main Results:

• A total of 12 embolization procedures were performed across the four patients.
• Three patients achieved complete seizure freedom; one showed significant seizure frequency reduction.
• No rescue surgery, hydrocephalus, or unexpected neurological complications occurred; functional improvements were reported.

Conclusions:

• Endovascular embolization is a promising minimally invasive strategy for pediatric refractory epilepsy.
• It is particularly beneficial when traditional surgery is precluded by anatomical or medical factors.
• Further research is needed to optimize patient selection and compare long-term efficacy with surgical approaches.