Seizure frequency, neuropsychological function, quality of life, and need for antiepileptic drugs were evaluated in 33 consecutive children following epilepsy surgery at 12 years of age or younger at the University of Alabama at Birmingham and the Cleveland Clinic Epilepsy Centers. Two thirds were seizure-free after a mean follow-up of 3 years, and only 4 showed no improvement. Antiepileptic drugs were discontinued in 30%, and a similar percentage of patients tested psychologically showed a more than 10 point improvement in Verbal or Performance IQ. One patient had a mild hemiparesis and another a quadrantanopia. Inferior scores noted in quality of life questionnaires were unexplained. [1]
COMMENT. This study confirms that surgery can be an effective treatment of refractory epilepsy in children, and surgical complications are unusual. The selection of patients is aided by video/EEG monitoring of seizures, intracranial monitoring or electrocorticography at the time of surgery, and PET or ictal SPECT imaging in some cases.