Functional neurosurgery continues to evolve rapidly, driven by advances in medical technology and increased understanding of neural networks underlying functional disorders, including epilepsy, movement disorders, pain, and neuropsychiatric diseases. Neurosurgical interventions have allowed patients with these very complex conditions to attain an improved quality of life through less-invasive, safer, and, in many, more effective treatment algorithms to improve outcomes compared with continued failed medical management. These innovative surgical therapies are in large part facilitated by advances in neuroimaging, neurophysiology, invasive neuromonitoring, minimally invasive neurosurgery, including laser thermal therapy, and neuromodulation.
Unfortunately, most of these advances have been reported in adults while children are often diagnosed and "treated" off label. Although to most people children are not just "little adults," there is scant information as to the optimal diagnosis and surgical management for this population. Given the expected impact of these diseases and disorders on normal neural development, psychosocial impact, and quality of life, our goal with this issue of Neurosurgical Focus was to provide an initial overview of functional diseases in children, their diagnosis, and neurosurgical management. As will be highlighted, we have chosen a cross-section of papers highlighting different pathologies, the noninvasive and invasive methods to identify their associated pathological networks, and the early experience from around the globe for the surgical management of the pediatric patient through novel technologies and techniques. We hope that this early experience will highlight the extent of the challenges faced by children and the opportunity for all of us to apply novel and innovative technologies to the management of pediatric functional disease in the future.