Abstracts

Rationale: To evaluate the surgical, developmental outcomes and safety issues in infants under 2 years undergoing epilepsy surgery. Methods: We identified 38 patients younger than ages of 2 years who underwent resective surgery at Severance Children's Hospital in Seoul, Korea, from February, 2003 to August, 2011. Etiology, post-operative seizure outcomes, pre and post-operative cognitive function, re-operation rates and complications were analyzed by retrospective examination of clinical data. Results: All patients had intractable epilepsy and thirty-four patients had an epileptogenic lesion visible on brain MRI. Most frequent etiologies were predominantly malformation of cortical development (28), and the rest were Sturge-Weber syndrome (4), destructive encephalopathy (1), tumor (1), tuberous sclerosis complex (1), and others (1). The median age at surgery was 12 months (range 0.2-2 years) and lead time to surgery was 0.7 years (range 0.1-1.9 years). Surgeries were functional hemispherectomy (53%) , lobar or multilobar resection and 1 posterior quadrantectomy. In twelve children, re-operation was carried out. At last follow-up (median 3.4 years), 78% of patients were in Engel Class I and thirteen of them successfully discontinued AED without seizure relapse. There were 2 perioperative mortalities. The most common surgical complications among the 52 operations in 37 patients were hydrocephalus (6). Conclusions: Out results show that epilepsy surgery in infancy can be relatively safely performed with satisfactory long-term results.