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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Seven years of epilepsy surgery in Freiburg: outcome with regard to epileptic seizures in 100 children 1-16 years of age

Sieben Jahre Epilepsiechirurgie in Freiburg: Ergebnisse epilepsiechirurgischer Eingriffe bei 100 Kindern von 1 bis 16 Jahren

Meeting Abstract

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  • corresponding author S. Rona - Epilepsy Center, Dept. of Neurosurgery, University of Freiburg
  • K. Strobl - Epilepsy Center Kork, Kehl-Kork
  • T. Bast - Children's Hospital, University of Heidelberg
  • J. Honegger - Dept. of Neurosurgery, University of Freiburg
  • C. Scheiwe - Dept. of Neurosurgery, University of Freiburg
  • J. Zentner - Dept. of Neurosurgery, University of Freiburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc10.05.-06.05

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0114.shtml

Published: May 4, 2005

© 2005 Rona et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

Surgery represents an additional therapeutic option for drug-resistant focal epilepsies in childhood. The results of surgical procedures for epilepsy performed on 100 children are presented.

Methods

Between January 1998 and July 2004, epilepsy surgery was performed on 100 children between 1-16 years of age. Demographical data, aetiology of the epilepsy, details of the presurgical workup, localisation and type of surgery were documented and analysed retrospectively. The seizure outcome was determined at fixed intervals 6, 12, 18, 24, 36, 48, and 60 months after surgery and classified according to Engel et al.

Results

Prior to surgery, all children were evaluated with non-invasive long-term video-EEG telemetry, 33 children had additional invasive monitoring with implanted electrodes, 26 children had intraoperative electrocorticography. A cortical resection with or without amygdalohippocampectomy (AHE) was performed on 91 children, 4 had a selective AHE and 4 had a functional hemispherectomy. One patient had only multiple subpial transections. The localisation was temporal in 46, monolobar extratemporal in 29 and multilobar/hemispheric in 25 patients. The aetiology of the epilepsy was cortical dysplasia in 56, tumour in 24, (perinatal) ischemia in 6, tuberous sclerosis in 4, Rasmussen's encephalitis in 2 and other in 8 children. Unexpected postoperative permanent neurological deficits occurred only in 3 patients (2 pareses, 1 partial aphasia). Depending on the point of observation during follow-up, 68-75% of children were completely free of seizures, up to 8% had only non-disabling simple partial seizures, about 10% had rare disabling seizures. Only 4-12% of patients did not improve after surgery. The best outcome was achieved in patients with temporal resections; there were no significant differences regarding the aetiology.

Conclusions

Our results confirm the validity of surgical therapy for drug-resistant focal epilepsies in childhood. While some patients had seizure recurrences even several years after surgery, the overall outcome remained stable over time.