Surgical Results in Pediatric Patients with Intractable Epilepsy: In Aspects of Development and Cognitive Function

ABSTRACT

OBJECTIVE: This study is designed to investigate whether early surgery can result in a better outcome for seizure control and brain development in pediatric patients with intractable epilepsy. METHODS: Preoperative evaluation methods for surgery included history taking, neurological examination, chronic video-EEG monitoring with surface and subdural grid electrodes, magnetic resonance image(MRI), 3-dimensional surface rendering with MRI, PET and SPECT. The Denver Developmental Screening Test II, and the Full Scale Intelligence Quotient(FSIQ) were evaluated for developmental status before and after surgery. Seizure outcome was classified according to Engel's classification. Surgical procedures included temporal lobectomy in four subjects, extratemporal resection in 14, callosotomy in one and tumor removal in one. RESULTS: Seizure outcomes were class I in 11 patients(55%), class II in three(15%), class III in 4(20%) and class IV in two(10%). Under the age of 6 years, the preoperative average developmental delay was 12.4 months. Postoperatively, two of them caught up to their normal developmental status. Over the age of 6 years, the preoperative average FSIQ was 87.5 and the postoperative average FSIQ was 103.3. CONCLUSION: In pediatric patients with intractable epilepsy, the early surgical treatment is very helpful in the normalization of their brain function.