The surgical treatment of intractable childhood and adolescent epilepsy

The approach to the surgical management of intractable epilepsy of the Adelaide Children's Hospital, and a method of anaesthesia allowing intraoperative electrocorticographic recordings, are described. Using this approach, the outcome of ablative neurosurgery in a heterogenous group of sixteen childhood and adolescent epileptics is presented. This group was characterized by poorly controlled seizure disorders and interictal behavioural abnormalities. Investigations suggested that all patients had focal epileptogenic lesions. Postoperative seizure control and psychosocial adjustment were improved in 13 (81%) and 12 (75%) patients respectively. The place for, and limitations of, antiepileptogenic surgery are discussed.