Children requiring surgical treatment of epilepsy present many periope
rative challenges. Anesthetic agents affect both the seizure threshold
and the ability to monitor behavioral and electrophysiological functi
ons. Furthermore, patients receiving chronic anticonvulsant therapy ha
ve altered responses to many anesthetic drugs. Special considerations
must also be given to the needs and requirements of pediatric patients
. This article reviews concerns relevant to the preoperative, intraope
rative, and immediate postoperative anesthetic management of these pat
ients.