EPILEPSY SURGERY IN CHILDREN

The practice of operating on children with chronic epilepsy is rapidly gaining acceptance as an important therapeutic modality. This review summarizes some of the recent advances in pediatric epilepsy surgery i n relation to the natural history of chronic childhood seizures, surgi cal treatment, and outcome. Candidate selection has been greatly facil itated by new information bearing on the natural history of medically resistant seizures and the greater than expected incidence of early hi ppocampal sclerosis. Because the majority of children suffer from extr atemporal epilepsy, ictal single photon emission computed tomography a nd subdural electroencephalogram recording are becoming increasingly i mportant for both seizure and functional localization in the child, an d have been shown to be well tolerated, even in very young patients. F urthermore, the outcome of both excisional and commissural procedures in early life with respect to seizure control is similar to that repor ted for adults, irrespective of age. More information about the long-t erm effects of epilepsy surgery in children is urgently needed, but th e available data confirms surgical therapy as an effective interventio n with low morbidity.