Journal of Pediatric Epilepsy 2021; 10(02): 088-096
DOI: 10.1055/s-0040-1722298
Review Article

Pediatric Epilepsy Surgery in Focal and Generalized Epilepsy: Current Trends and Recent Advancements

William B. Harris
1  John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i
,
2  Department of Neurosurgery, University of California Los Angeles, California, United States
,
Aria Fallah
2  Department of Neurosurgery, University of California Los Angeles, California, United States
,
Gary W. Mathern
2  Department of Neurosurgery, University of California Los Angeles, California, United States
3  Department of Psychiatry and Biobehavioral Medicine, David Geffen School of Medicine at UCLA, California, United States
› Author Affiliations
Funding G.W.M. received support from the Davies/Crandall Endowed Chair for Epilepsy Research, and The National Institutes of Health (grant number R01 NS38992).

Abstract

For a subset of children with medically intractable epilepsy, surgery may provide the best chances of seizure freedom. Whereas the indications for epilepsy surgery are commonly thought to be limited to patients with focal epileptogenic foci, modern imaging and surgical interventions frequently permit successful surgical treatment of generalized epilepsy. Resection continues to be the only potentially curative intervention; however, the advent of various neuromodulation interventions provides an effective palliative strategy for generalized or persistent seizures. Although the risks and benefits vary greatly by type and extent of intervention, the seizure outcomes appear to be uniformly favorable. Advances in both resective and nonresective surgical interventions provide promise for improved seizure freedom, function, and quality of life. This review summarizes the current trends and recent advancements in pediatric epilepsy surgery from diagnostic workup and indications through surgical interventions and postoperative outcomes.



Publication History

Received: 16 November 2020

Accepted: 01 November 2020

Publication Date:
20 January 2021 (online)

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany