@article {66011, title = {Pediatric epilepsy surgery: long-term 5-year seizure remission and medication use}, journal = {Neurosurgery}, volume = {71}, year = {2012}, month = {Feb-08-2013}, pages = {985 - 993}, abstract = {

Background:\ It is unclear whether long-term seizure outcomes in children are similar to those in adult epilepsy surgery patients.

Objective:\ To determine 5-year outcomes and antiepilepsy drug (AED) use in pediatric epilepsy surgery patients from a single institution.

Methods:\ The cohort consisted of children younger than 18 years of age whose 5-year outcome data would have been available by 2010. Comparisons were made between patients with and without 5-year data (n = 338), patients with 5-year data for seizure outcome (n = 257), and seizure-free patients on and off AEDs (n = 137).

Results:\ Five-year data were available from 76\% of patients. More seizure-free patients with focal resections for hippocampal sclerosis and tumors lacked 5-year data compared with other cases. Of those with 5-year data, 53\% were continuously seizure free, 18\% had late seizure recurrence, 3\% became seizure free after initial failure, and 25\% were never seizure free. Patients were more likely to be continuously seizure free if their surgery was performed during the period 2001 to 2005 (68\%) compared with surgery performed from 1996 to 2000 (61\%), 1991 to 1995 (36\%), and 1986 to 1990 (46\%). More patients had 1 or fewer seizures per month in the late seizure recurrence (47\%) compared with the not seizure-free group (20\%). Four late deaths occurred in the not seizure-free group compared with 1 in the seizure-free group. Of patients who were continuously seizure free, 55\% were not taking AEDs, and more cortical dysplasia patients (74\%) had stopped taking AEDs compared with hemimegalencephaly patients (18\%).

Conclusion:\ In children, 5-year outcomes improved over 20 years of clinical experience. Our results are similar to those of adult epilepsy surgery patients despite mostly extratemporal and hemispheric operations for diverse developmental etiologies.

}, issn = {0148-396X}, doi = {10.1227/NEU.0b013e31826cdd5a}, url = {https://academic.oup.com/neurosurgery/article/71/5/985/2595469http://academic.oup.com/neurosurgery/article-pdf/71/5/985/32585196/00006123-201211000-00011.pdfhttp://academic.oup.com/neurosurgery/article-pdf/71/5/985/32585196/00006123-201211000-00011.pdf}, author = {Hauptman, Jason S. and Pedram, Kayvon and Sison, Christia Angela and Sankar, Raman and Salamon, Noriko and Vinters, Harry V. and Mathern, Gary W.} }