Abstracts

Rationale: Epilepsy surgery in the treatment of intractable epilepsy in childhood has been known as one of the most effective treatment methods. The aim of this study is to investigate the clinical manifestations and the surgical outcome of our patients with intractable epilepsy. Methods: We performed a retrospective study on 34 patients with intractable pediatric epilepsy who received epilepsy surgery between Mar. 2009 and Jul. 2011 at Severance Children's Hospital. Clinical characteristics, presurgical evaluation and surgical outcomes were reviewed. Results: The study group included 20 boys and 14 girls; mean age at seizure onset was 3.68 years (range, 1 month- 16.5 years). All patients involved in the study suffered frequent seizures despite multiple trials of antiepileptic medications, and some had tried a ketogenic diet. The etiologies of those patients were malformation of cortical development, destructive encephalopathy, hippocampal sclerosis, hypothalamic hamartoma, tuberous sclerosis, and 23.4% of cases were cause unknown epilepsy. Among 34 patients, the patients with symptomatic localized related epilepsy was 16, the patients with Lennox-Gastaut syndrome was 9, the patients with Infantile spasms was 7, and the patients with other type of epileptic syndromes was 2. According to the individual results of presurgical evaluation, 24 patients got resective surgeries (unilobar resection, multilobar resection, functional hemispherectomy, and removal of hamartoma) for curative purpose and 10 patients got corpus callosotomy for palliative purpose. Postoperatively, 24 patients (70.6 %) were seizure free (Engel class I). However, 10 patients (29.4 %) got unfavorable results (Engel class III or IV). Among the 24 patients who got resective surgery, 18 patients (75%) was favorable outcome of seizure free, and 6 patient (60%) of the 10 patients who got palliative surgery became seizure free. Conclusions: This study demonstrates that significant rate of pediatric patients with intractable epilepsy can obtain favorable seizure outcome by surgical treatment.