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Benefits Seen From Early Epilepsy Surgery

Age under 3 not a surgical contraindication in children with refractory epilepsy

FRIDAY, April 3 (HealthDay News) -- Surgery to treat epilepsy in young children appears generally safe and effective, according to research published online ahead of print Jan. 21 in Epilepsia.

Paul Steinbok, M.D., of the British Columbia Children's Hospital in Vancouver, Canada, and colleagues reviewed data on 116 patients younger than 3 years of age who underwent epilepsy surgery from 1987 to 2005 in Canada. Common causes of epilepsy in the children included cortical dysplasia, Sturge-Weber syndrome, and hemimegalencephaly.

The mean age at first surgery was 15.8 months, the researchers report. The children had 40 hemispheric surgeries (mostly functional hemispherectomies and periinsular hemispherotomies), 35 lesionectomies, 33 focal cortical resections, seven temporal lobectomies and a corpus callosotomy. Twenty-seven patients needed a second operation, and six needed a third. The authors noted one surgical mortality, and morbidities included infections and aseptic meningitis. Of patients evaluated more than a year after surgery, 67.3 percent were seizure free.

"The results of this relatively large study corroborate the findings in other smaller reported series and indicate that epilepsy surgery in children younger than 3 years of age is effective for control of epilepsy and can be performed with acceptable morbidity and mortality. In the light of the negative impact of seizures and antiepileptic drugs on the developing brain, surgical intervention should be considered even in young infants if seizures are poorly controlled," the authors conclude.

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