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Journal of Pediatric Epilepsy 2023; 12(01): 003-008
DOI: 10.1055/s-0042-1759876
Review Article

An Introduction to Minimally Invasive Pediatric Epilepsy Surgery

James J. Riviello Jr.
1   Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, Unites States
2   Department of Neurology, Texas Children's Hospital, Houston, Texas, Unites States
,
Daniel J. Curry
3   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, Unites States
4   Division of Pediatric Neurosurgery, Department of Surgery, Texas Children's Hospital, Houston, Texas, Unites States
,
Howard L. Weiner
3   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, Unites States
4   Division of Pediatric Neurosurgery, Department of Surgery, Texas Children's Hospital, Houston, Texas, Unites States
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Abstract

The field of minimally invasive surgery has evolved over the past 50 years, including neurosurgery, with an evolution to “minimally invasive neurosurgery” when feasible. Epilepsy surgery has followed this trend, with a transition from standard neurosurgical techniques to minimally invasive techniques in all phases of neurosurgical involvement. These include the diagnostic intracranial electroencephalogram with a subdural exploration to stereoelectroencephalography, the actual resection from an open craniotomy to a less destructive technique, or the multiple modalities of neuromodulation instead of a destructive surgery.

The influence of these minimally invasive techniques has resulted in a change in the overall philosophy of pediatric epilepsy surgery. The expectations of what is considered “successful” epilepsy surgery has changed from total seizure control, in other words, a “cure,” to palliative epilepsy surgery with a decrease in the targeted seizures, especially “disabling seizures.” This has led to an overall greater acceptance of epilepsy surgery. This article summarizes the major reasons behind the explosion of minimally invasive pediatric epilepsy surgery, which are amplified in the subsequent articles. Some of this chapter includes the authors' opinions.

Keywords

pediatric epilepsy surgery - epilepsy


Publication History

Received: 12 November 2022

Accepted: 12 November 2022

Article published online:
22 December 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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