15 Years of Pediatric Epilepsy Surgery in Vogtareuth

Abstract

From November 1998 to December 2013, 430 children, adolescents, and young adults with drug-resistant focal epilepsies have undergone epilepsy surgery at our center. Here, we report the demographic data, etiologies, surgical procedures, and seizure outcomes (minimum follow-up 6 months, average 6.8 years). Epilepsy onset ranged from 1 month to 20 years (mean, 3.3 years), age at surgery ranged from 9 months to 34 years (mean, 9.2 years). Etiologies were focal cortical dysplasias (n = 179), cystic-gliotic lesions (n = 88), tumors (n = 64), phakomatoses (n = 22), hippocampal sclerosis (n = 20), other cortical malformations (n = 33), Rasmussen encephalitis (n = 9), nonlesional (n = 6), other (n = 9). Surgical procedures were hemispherotomies (n = 92), frontal lobe resections (n = 60), temporal lobe resections (n = 87), bi- and multilobar resections (n = 148), subtotal hemispheric resections (n = 18), other (n = 25). A second operation was performed in 49 and a third operation in 6 patients; overall, 31 of these 49 patients (63%) benefitted from the reoperation. Epilepsy outcome (Engel classification): Seizure free (1a) 57%, auras only (1b) 7%, > 90% seizure reduction (2) 11%, > 50% seizure reduction (3) 11%, unchanged (4) 10%, no postoperative follow-up yet 4%.