Gudrun Gröppel1, Christian Dorfer2, Anastasia Dressler1, Angelika Mühlebner1, Barbara Porsche1, Thomas Czech2, Daniela Prayer3, Martha Feucht4. 1. Department of Pediatrics and Adolescence Medicine, Epilepsy Monitoring Unit, MUW/AKH Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. 2. Department of Neurosurgery, MUW/AKH Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. 3. Department of Radiology, MUW/AKH, Währinger Gürtel 18-20, 1090, Vienna, Austria. 4. Department of Pediatrics and Adolescence Medicine, Epilepsy Monitoring Unit, MUW/AKH Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. martha.feucht@meduniwien.ac.at.
Abstract
PURPOSE: To evaluate the efficacy and safety of epilepsy surgery in infants. METHODS: Included were patients with epilepsy onset during the first year of life, epilepsy surgery before the age of 36 months at the study center and a minimum follow-up of 24 months after surgery. Patients who were surgically treated before the age of 12 months were compared with those between 13 and 36 months. Group differences with respect to efficacy (seizure outcomes and developmental progress measured by the social interaction quotient, SIQ) as well as safety (i. e. peri-operative complication rates) were analyzed. RESULTS: A total of 20 patients (10 girls) were included: 10 (five girls) were operated on as infants (median age at surgery 9.0 months, median disease duration prior to surgery 5.0 months) and 10 (5 girls) were operated on as toddlers (median age at surgery 24.0 months, median disease duration prior to surgery 18.0 months). Favorable seizure outcomes (Wieser 1a and 1) were seen in 80% (8/10) of the infants and 60.0% (6/10) of toddlers. Developmental progress was most evident in infants who were seizure-free and off medication (median SIQ 85.5 versus 63.0 in the toddler group). There were no differences between the two groups with respect to safety aspects. CONCLUSION: Despite several limitations due to the small number of patients included, our results are in favor of early epilepsy surgery in infants with drug-resistant epilepsy.
PURPOSE: To evaluate the efficacy and safety of epilepsy surgery in infants. METHODS: Included were patients with epilepsy onset during the first year of life, epilepsy surgery before the age of 36 months at the study center and a minimum follow-up of 24 months after surgery. Patients who were surgically treated before the age of 12 months were compared with those between 13 and 36 months. Group differences with respect to efficacy (seizure outcomes and developmental progress measured by the social interaction quotient, SIQ) as well as safety (i. e. peri-operative complication rates) were analyzed. RESULTS: A total of 20 patients (10 girls) were included: 10 (five girls) were operated on as infants (median age at surgery 9.0 months, median disease duration prior to surgery 5.0 months) and 10 (5 girls) were operated on as toddlers (median age at surgery 24.0 months, median disease duration prior to surgery 18.0 months). Favorable seizure outcomes (Wieser 1a and 1) were seen in 80% (8/10) of the infants and 60.0% (6/10) of toddlers. Developmental progress was most evident in infants who were seizure-free and off medication (median SIQ 85.5 versus 63.0 in the toddler group). There were no differences between the two groups with respect to safety aspects. CONCLUSION: Despite several limitations due to the small number of patients included, our results are in favor of early epilepsy surgery in infants with drug-resistant epilepsy.
Entities:
Keywords:
Development; Epileptic seizures; Postoperative outcome; Young children
Authors: Jo M Wilmshurst; William D Gaillard; Kollencheri Puthenveettil Vinayan; Tammy N Tsuchida; Perrine Plouin; Patrick Van Bogaert; Jaime Carrizosa; Maurizio Elia; Dana Craiu; Nebojsa J Jovic; Doug Nordli; Deborah Hirtz; Virginia Wong; Tracy Glauser; Eli M Mizrahi; J Helen Cross Journal: Epilepsia Date: 2015-06-30 Impact factor: 5.864
Authors: Georgia Ramantani; Navah Ester Kadish; Karl Strobl; Armin Brandt; Angeliki Stathi; Hans Mayer; Susanne Schubert-Bast; Gert Wiegand; Rudolf Korinthenberg; Ulrich Stephani; Vera van Velthoven; Josef Zentner; Andreas Schulze-Bonhage; Thomas Bast Journal: Eur J Paediatr Neurol Date: 2013-04-18 Impact factor: 3.140
Authors: Bruno Maton; Prasanna Jayakar; Trevor Resnick; Glenn Morrison; John Ragheb; Michael Duchowny Journal: Epilepsia Date: 2007-09-12 Impact factor: 5.864
Authors: M Duchowny; P Jayakar; T Resnick; A S Harvey; L Alvarez; P Dean; J Gilman; I Yaylali; G Morrison; A Prats; N Altman; S Birchansky; J Bruce Journal: Epilepsia Date: 1998-07 Impact factor: 5.864