Epilepsy surgery in children under 3 years

C. Dunkley, J. Kung, R. C. Scott, P. Nicolaides, B. Neville, S. E. Aylett, W. Harkness, J. H. Cross

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49 Citations (Scopus)

Abstract

Purpose: Resective epilepsy surgery in early childhood has become an important treatment option for selected infants and children with epilepsy. We describe experience and clinical outcomes of children under 3 years undergoing epilepsy surgery at Great Ormond Street Hospital (GOSH). Methods: All children under 36 months of age who had resective surgery for the purpose of treating epilepsy within the GOSH epilepsy surgery programme were ascertained using a departmental database. Aetiology, post-operative seizure frequency, pre and post-operative cognitive function, long-term complications and re-operation rates were analysed by retrospective examination of clinical records. Results: Forty-two children were included in our cohort with a median age at surgery of 20 months (range 3-36 months). Surgical procedures comprised 25 functional hemispherectomies, two anatomical hemispherectomies, four multilobar resections, seven lobar resections and four focal resections. 7/42 (17%, 95% CI 8-31%) children underwent re-operation. 20/42 (48%, 95% CI 33-62%) children achieved seizure freedom. 18/42 (43%, 95% CI 29-58) demonstrated an improvement in seizure frequency and no children had an increase in seizure frequency. Post-operative complications included subsequent shunt procedure in 5/25 (20%, 95% CI 9-39%) children undergoing hemispherectomy. There were no mortalities. In 23 children pre- and post-operative DQ or IQ was determinable allowing longitudinal comparison. Five children had a decrease in DQ/IQ >15 and two children had an increase DQ/IQ >15. Discussion: Epilepsy surgery in children under 3 years of age offers suitable candidates a good chance of significantly improved seizure outcome which compares with rates in older cohorts.

Original languageEnglish
Pages (from-to)96-106
Number of pages11
JournalEpilepsy Research
Volume93
Issue number2-3
DOIs
Publication statusPublished - Feb 2011

Keywords

  • Epilepsy
  • Focal seizures
  • Outcome
  • Surgery
  • Young children

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    Dunkley, C., Kung, J., Scott, R. C., Nicolaides, P., Neville, B., Aylett, S. E., Harkness, W., & Cross, J. H. (2011). Epilepsy surgery in children under 3 years. Epilepsy Research, 93(2-3), 96-106. https://doi.org/10.1016/j.eplepsyres.2010.11.002