PREOPERATIVE EEG CORRELATES OF SEIZURE OUTCOME FROM EPILEPSY SURGERY IN CHILDREN

To identify criteria for selecting pediatric candidates for cortical r esection, we compared preoperative standard EEGs, extracranial or intr acranial (subdural strip or grid) electrode EEG-video monitoring and i maging studies, and surgical pathology findings with long-term (mean = 6.1 years) seizure outcome. Of 47 children, 83% were either seizure-f ree or substantially improved. Children with a predominant single inte rictal focus in standard EEGs over time or with seizures that were mos tly well localized (even with equal numbers of bilaterally independent spikes) during monitoring had significantly better outcomes than thos e who had mostly diffuse or bilaterally independent interictal and ict al discharges. Factors not associated with poor outcomes were some sei zures unaccompanied by ictal EEG patterns, spikes in postresection ele ctrocorticograms, extratemporal resection, younger age at surgery, and older age of seizure onset. Significantly more patients with than wit hout tumors were seizure-free. Significantly more preteenagers than te enagers had poorly localized interictal and ictal discharges.