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Seung-Ki Kim, Kyu-Chang Wang, Yong-Seung Hwang, Ki Joong Kim, Jong Hee Chae, In-One Kim, and Byung-Kyu Cho

candidates for surgery and for avoiding treatment-related irreversible side effects. However, few postsurgical clinical outcome data are available from pediatric series because of a limited number of patients. The results of epilepsy surgery in children have remained relatively constant: 58–74% of carefully selected patients become seizure free, and a higher percentage (67–82%) exhibit favorable seizure control (Engel Class I or II outcome). 18 , 19 , 27 , 29 , 31 These rates indicate that a substantial proportion of patients treated with surgery continue to experience

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Zulma S. Tovar-Spinoza, Ayako Ochi, James T. Rutka, Cristina Go, and Hiroshi Otsubo

P ediatric epilepsy surgery is a constantly evolving field that offers patients with drug-resistant epilepsy a better chance for seizure control without causing additional morbidity. Over the years, advances in the knowledge of neuromagnetism have allowed for the integration of MEG data with MR imaging to produce magnetic source images. Magnetoencephalography has proven to be a valuable presurgical tool in identifying the epileptogenic zone and eloquent brain cortex, and in predicting surgical outcomes in a subset of children with intractable epilepsy. 27

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Allen R. Wyler, Bruce P. Hermann, and E. T. Richey

T here is a certain percentage of patients for whom epilepsy surgery does not acceptably reduce seizure frequency. In such cases, the surgeon may consider reoperation in the hope of improving the seizure outcome. Very little has been written concerning the indications, morbidity, and outcome of reoperation although it is practiced in several epilepsy centers. The purpose of this paper is to review the outcome of our series of 37 repeat epilepsy operations. Repeat surgery involved focal resections after initial focal resections or stereotactic lesion placement

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Taner Tanriverdi, Abdulrazag Ajlan, Nicole Poulin, and Andre Olivier

I t has been clearly demonstrated that surgical treatment for intractable epilepsy is an effective and safe treatment. It leads to seizure freedom in > 75% of patients who suffer from TLE 1 , 25 , 37 , 49 and in 50 to 70% of those who suffer from extratemporal lobe epilepsy, 22 , 27 , 60 and it improves their QOL. 10 , 46 , 51 , 52 Although epilepsy surgery is safe and effective, it is not free of complications. Epilepsy surgery exhibits some peculiarities that are not common in other neurosurgical procedures. A unique feature of epilepsy surgery is

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Donato Pacione, Francine Blei, Orrin Devinsky, Howard L. Weiner, and Jonathan Roth

antidepressants such as SSRIs, which can inhibit platelet function and lead to bleeding disorders. 12 , 23 Multiple AEDs may be required concurrently, which may hamper hepatic synthesis of coagulation factors. We reviewed our routine and prospective evaluation of coagulation functions among children scheduled to undergo epilepsy-related surgery. Methods Since December of 2007, we have routinely and prospectively sent all patients who had refractory seizures and who were candidates for epilepsy surgery for hematological evaluation. The initial trigger for this routine was

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George M. Ibrahim, Benjamin W. Barry, Aria Fallah, O. Carter Snead III, James M. Drake, James T. Rutka, and Mark Bernstein

guidelines has been proposed for pediatric patients, 6 many children continue to face barriers in access to surgical interventions. In an international survey of pediatric epilepsy surgery centers, the mean duration of the disorder before surgery was 5.7 years, with significantly longer mean times for older children. 13 More importantly, this study also found that only a minority of children at greatest risk of epileptic encephalopathy received time-appropriate surgery. Particular patient populations at risk include children with refractory infant-onset epilepsies, in

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Attila Rácz, Kathryn Menne, Valeri Borger, Kevin G. Hampel, Hartmut Vatter, Christoph Helmstaedter, Christian E. Elger, and Rainer Surges

A pproximately one-third of people with epilepsy develop medically refractory epilepsy. 1 In many instances, epilepsy surgery can render patients with medically refractory focal epilepsy seizure free, which may also allow a stepwise reduction of antiseizure therapy. Therefore, presurgical diagnostic evaluation in this patient group is of utmost importance. Epidemiological studies revealed that the overall proportion of elderly patients with epilepsy is constantly increasing, 2–4 which is due to cerebrovascular insults, neurodegenerative diseases

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Ashley G. Tian, Michael S. B. Edwards, Nicole J. Williams, and Donald M. Olson

studies (1.5- or 3.0-T MR imaging), gliosis resulting from the initial resection, and adjacent cortical dysplasia associated with the original tumor but not identified or included in the original resection. We report on 9 children who developed chronic, medically refractory epilepsy after their initial tumor resection and subsequently required epilepsy surgery a long time after their initially successful tumor resection. Methods Patient Population Between 2005 and 2009, 9 children ranging in age from 9 to 17 years old at the time of epilepsy surgery were

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Jessica S. Lin, Sean M. Lew, Charles J. Marcuccilli, Wade M. Mueller, Anne E. Matthews, Jennifer I. Koop, and Mary L. Zupanc

callosotomy, were identified as having consistent unilateral focal regions of seizure onset and underwent further resection, with subsequent significant reductions in seizures. In this regard, callosotomy can serve both therapeutic and diagnostic purposes. Since 2003, we have combined corpus callosotomy with the placement of bilateral subdural electrodes as the first planned stage in multistage epilepsy surgery in a very select subset of patients. To our knowledge, no published literature has documented the results of such a protocol. We reviewed the outcomes in this

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Benoit Jenny, Nicolas Smoll, Yassine El Hassani, Shahan Momjian, Claudio Pollo, Christian M. Korff, Margitta Seeck, and Karl Schaller

diagnosis in children undergoing epilepsy surgery. 22 Early surgical treatment in children with intractable epilepsy is expected to allow the healthy brain to recover and develop, without the child suffering from the consequences of continuous seizure activity. Better postoperative development outcomes have been noted in children under 3 years old, 30 and the likely explanations for these findings include greater neural plasticity of the brain at this age. 4 , 15 , 16 , 20 , 38 , 39 Furthermore, there is evidence that AEDs have an ominous role in cognitive development