Yield and Predictors of Epilepsy Surgery Candidacy in Children Admitted for Surgical Evaluation

Haque, Omar; Mandrekar, Jay; Wyatt, Kirk D; Nickels, Katherine C.; Wong‐Kisiel, Lily C.; Wetjen, Nicholas M.; Wirrell, Elaine

doi:10.1016/j.pediatrneurol.2015.03.022

Cited by 5 publications

(1 citation statement)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are seven preadmission predictors for surgical candidacy: single semiology at seizure onset, structural etiology, one or more interictal foci in the same hemisphere, focal background electroencephalograph slowing, focal or hemispheric abnormality on magnetic resonance imaging, male sex, and normal development. In the presence of more than four factors, 91% were found to be surgical candidates [6]. Therefore, early surgery is recommended for those who are suitable for surgery in order to avoid intellectual and cognitive deterioration [7,8].…”

Section: Discussionmentioning

confidence: 99%

Early surgical intervention for structural infantile spasms in two patients under 6 months old: a case report

Yang

Peng

et al. 2020

Acta Epileptologica

View full text Add to dashboard Cite

Background Infantile spasms (IS) are the most common childhood epileptic encephalopathy. Focal cortical dysplasia (FCD) and gray matter heterotopias (GH) are common structural causes of IS. The recommended first-line treatment for IS patients with structural causes is surgical intervention, according to the International League Against Epilepsy (ILAE) commission guidelines. However, there is currently no consensus on appropriate timings of surgery. Case presentations Two structural IS cases are presented here: one was caused by FCD, and the other by GH. Both patients exhibited recurrent seizures at the age of 2 months, had poor responses to various antiepileptic drugs (AEDs) and displayed severe mental and motor developmental retardation. Seizure types included focal seizures and spasms. Brain magnetic resonance imaging showed abnormal gray signal or suspicious FCD lesions that coincided with the origin of the focal seizures. The patients underwent lesion resection before the age of 6 months. Follow-up observation showed that seizures of both patients were completely controlled several days after the surgery. All AEDs were gradually reduced in dosage within 1 year, and the mental and motor development almost returned to normal. Conclusion Early resection of lesions in structural IS patients has benefits of effectively controlling convulsions and improving developmental retardation. Infants at several months of age can well tolerate craniotomy, and their cognitive development is more likely to return to normal after early surgery.

show abstract

Section: Discussionmentioning

confidence: 99%