Surgical Treatment For Symptomatic Epilepsy In Children

Objective: To investigate the cause, clinical characteristics and the experience in surgical treatment of symptomatic epilepsy in children.Methods: A retrospective analysis was made of 27 children with secondary epilepsy who were operated on from January 1997 to december 2004. All of them were presurgical evaluated and localized by all kinds of means. Under the monitor of cortical electroencephalogram (ECoG), 14 cases received lesionectomy only while 13 others underwent lesionectomy combined with other techniques, such as epileptogenic focus resection, multiple subpial transection (MST), cortex thermocoagulation and corpus callostomy. 11 cases who's lesions located in anterior temporal lobe or middle temporal lobe underwent anterior temporal lobectomy. To compare the seizures frequency and the kinds of oral administration AEDs before operation and after. The postoperative outcomes were classified by improved Engel's classification.Result: No severe complication or mortality was happened in all patients. After operation, the average seizures frequency were 1.08±2.31 times every month, and 21 patients take one kind of AEDs, 5 patients take two kinds of AEDs, one patient takes three kinds of AEDs. They were significantly fewer than those before operation (P<0.01). The postoperative outcomes express: 18 cases were grade Ⅰ , 6 cases were grade Ⅱ, 3 cases were grade Ⅲ.Conclusion: For symptomatic epilepsy in children, the presurgical evaluation to localize epileptogenic focus has a important value. The combined operations with ECoG monitoring can obtain favorable outcome. They not only decrease seizures and the kinds of oral administration AEDs but also improve the prognosis and quality of life.