Surgical treatment of children with medically intractable epilepsy--outcome of various surgical procedures.
Outcome after temporal lobe resection, extratemporal resection, and corpus callosotomy was studied in 33 children aged 15 years or less with medically intractable epilepsy. Seizure-free control was achieved in 67% (6/9) of pediatric patients versus 67% (60/90) of adult patients receiving temporal lobe resection and in 33% (4/12) of pediatric patients versus 25% (7/28) of adult patients receiving extratemporal resection. Among patients suffering from drop attacks and generalized convulsive seizures, 42% (5/12) of pediatric patients versus 25% (6/24) of adult patients receiving corpus callosotomy became seizure-free. The most prominent histological diagnoses in temporal lobe resections were three cases of mesial temporal sclerosis, four of ganglioglioma, and two of neuronal migration disorders. Neuronal migration disorders were the main histology in extratemporal resections. Four of five patients with behavioral problems treated by corpus callosotomy exhibited improved hyperactivity and/or attention deficits. There was no surgical morbidity or mortality. The outcome of pediatric patients was at least as favorable as that of adult patients, and improvement of behavioral disturbances could be expected after surgery. Surgical treatment is an effective and safe procedure for children with medically intractable epilepsy.