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August 15, 2020
Accepted
February 13, 2022
Published
March 11, 2022
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Abstract
Background: Over recent years epilepsy surgery has gained its own place as standard of care for many cases of drug-resistant focal epilepsy. The aim of our paper is to briefly summarize major achievements in the field of epilepsy surgery in children and discuss emerging aspects.
Methods: Our review has a narrative and a systematic part. Articles included in the systematic part were original studies conducted over the last 10 years in pediatric populations with epilepsy. The quality of the studies was assessed using appropriate bias assessment tools.
Results: The vast majority of articles identified were retrospective studies. Although efficacy and safety of epilepsy surgery have been proven, it is still underused in many healthcare systems and a balance between thorough pre-surgical investigations and early intervention needs to be achieved. Cognitive function seems to be stabilized and preserved after different types of epilepsy surgery, and in the longer term clear benefits demonstrated related to seizure freedom and weaning from antiepileptic medication. Minimally invasive surgical methods are emerging as efficient and safe alternative options in many cases of patients with specific underlying conditions, but larger group data are needed. Finally, emerging genetic findings lead to discussion about the utility of epilepsy surgery in specific genetic conditions, while social and national inequalities remind the need for more flexible approaches.
Conclusions: Early referral and mindful selection of likely candidates, refinement of minimally invasive surgical methods, ways to benefit cognitive function and early antiepileptic drugs withdrawal are the current challenges that epilepsy surgery is encountered with.
Keywords
epilepsy surgery, children, minimally invasive methods, neurodevelopment, cognition, epilepsy challenges
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Copyright (c) 2022 Maria Gogou, Judith Helen Cross
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How to Cite
Gogou, M., & Cross, J. H. . (2022). Epilepsy surgery in childhood: what are the challenges that now need to be brought to the foreground?. Journal of the International Child Neurology Association, 1(1). https://doi.org/10.17724/jicna.2022.207
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