Lesson learned from early experience in pediatric epilepsy surgery

About 1% of children population may have seizure that is recurrent and occurred without provocation, known as epilepsy. Those children with epilepsy fall into two main categories: well-controlled with drug(s) and uncontrollable with medication. The latest is now called intractable epilepsy or medically refractory epilepsy or drug resistant epilepsy.

For intractable epilepsy, pediatric epilepsy surgery has grown as a treatment of choice in carefully selected candidates. Decades ago, surgical avenue for epilepsy was considered as a last resort in medically refractory focal epilepsy after failure of numerous antiepileptic drug trials spanning many years. There have been certain key developments that have catalyzed this paradigm to change. Now, epilepsy surgery for children is considered earlier.

Sixteen cases of pediatric epilepsy surgery will be presented here along with type of pathology, features, and syndromic cases, and outcome during follow up. Cortical dysplasia was the most frequent pathology encountered including gyral, lobar and hemispheric type. Family of syndromic epilepsy such as West syndrome was also found. It is obvious that epilepsy in childhood age has many different features compared to their adult counterpart. The challenge is increasing when there is no sophisticated facilities available, and the physicians have to rely on their capacity to diagnose, analyze, and make the decision whether he/she is the best candidate for surgery or not.