Artikel
Epilepsy surgery in children: perioperative results
Epilepsiechirurgie bei Kindern: perioperative Aspekte
Suche in Medline nach
Autoren
Veröffentlicht: | 4. Mai 2005 |
---|
Gliederung
Text
Objective
Epilepsy surgery in Children has some characteristics, notably patient care and preoperative evaluation. On the other hand, brain plasticity allows functional transfers after surgical resection. Perioperative aspects and complications of epilepsy surgery in children are presented.
Methods
During a 7-year period, from 1998 until 2004, 144 operative procedures in 126 Children were performed, 33=22% for invasive monitoring, 105=74% for therapeutic purpose: 18 temporal lesionectomies with Amygdalohippocampectomy (AHE), 4 selective AHEs, 67 cortical lesionectomies, 9 vagus nerve stimulators and 7 functional hemispherectomies. In 3 cases grid electrodes were explanted without possible resection.
Results
Three operative revisions were necessary (2%), 2 due to hematoma and 1 wound infection. 10 minor complications which were completely regredient within 3 months (7%) and 3 major complications (2%), 2 pareses and 1 partial dysphasia, occurred. Calculated deficits, for example quadrant anopsia due to occipital resection, are not mentioned since they were taken into account for better seizure control. Grid electrode implantation allowed surgical resection in 95%, no early grid explantation was necessary. More than 70% of the operated children remain seizure-free.
Conclusions
Epilepsy surgery in children is feasible with acceptable perioperative risks and good seizure control in more than 85%, but it should be performed in experienced centers.