RESULTS AND COMPLICATIONS AFTER REOPERATION FOR FAILED EPILEPSY SURGERY IN CHILDREN

The seizure outcome and neurological outcome in children who undergo r eoperation for failed epilepsy surgery have not been well documented, This retrospective study evaluated 20 children who underwent a second resective surgery for recurrent seizures, Four categories of patients were identified: (1) extension of the initial resection was performed in 8 patients; (2) 5 patients underwent lobectomy or corticectomy in a region remote from the original surgical site; (3) multilobar resecti on which may have included further resection of the initial procedure was accomplished in 4 patients; (4) hemispherectomy was performed in 3 patients, Patients with reoperation in the same lobe as the first pro cedure (group 1) had a 62% seizure-free rate, while 44% of patients in groups 2 and 3 were free from seizures at follow-up evaluation. Patie nts undergoing hemispherectomy had a 67% seizure-free rate, Significan t unexpected neurological deficits occurred in 3 patients who underwen t multilobar resection at reoperation, Complications included motor an d language deficits, Reoperation for intractable partial epilepsy is b eneficial in selected children, Patients who require multilobar resect ions may have higher risk of postoperative neurological deficit than t hose patients with reoperation in one lobe, These factors may be usefu l in counseling parents of children considering reoperation for recurr ent epilepsy.