Abstract
To assess the possibility of streamlining the decision process for epilepsy surgery in children with intractable epilepsy, the value of MRI, video EEG, and SPECT was investigated retrospectively in a study of 353 patients at the Lingfield Epilepsy Centre, Great Ormond Street Hospital, and Institute of Child Health, London, UK).
Highlights
To assess the possibility of streamlining the decision process for epilepsy surgery in children with intractable epilepsy, the value of MRI, video EEG, and SPECT was investigated retrospectively in a study of 353 patients at the Lingfield Epilepsy Centre, Great Ormond Street Hospital, and Institute of Child Health, London, UK)
In children with bilateral MRI abnormalities or normal scan, the probability of resective surgery was 78% in those with EEG-localized ictal onset compared to 9% with nonlocalized EEG (p
Ictal EEG video recordings provide confirmatory evidence of focal lesions, but in situations with limited resources, they may be reserved for children with bilateral MRI changes or normal MRI
Summary
To assess the possibility of streamlining the decision process for epilepsy surgery in children with intractable epilepsy, the value of MRI, video EEG, and SPECT was investigated retrospectively in a study of 353 patients at the Lingfield Epilepsy Centre, Great Ormond Street Hospital, and Institute of Child Health, London, UK). Of 238 children offered resective surgery, 215 (92%) had a unilateral localized lesion on MRI, 20 (8%) had bilateral imaging abnormalities, and 3 had normal imaging. In the group with unilateral localized structural abnormalities, EEG telemetry did not affect a decision to operate.
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