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|Title: ||Epilepsy surgery in children and adolescence; Phramongkutklao College of Medicine's experience.|
|Authors: ||Nabangchang, Charcrin|
|Issue Date: ||25-Nov-2005|
|Citation: ||Nabangchang C, Sakoolnamarka S, Paueksakon P, Chinvarun Y. Epilepsy surgery in children and adolescence; Phramongkutklao College of Medicine's experience. Journal of the Medical Association of Thailand. 2005 Nov; 88 Suppl 3(): S263-70|
|Type: ||Journal Article|
|Abstract: ||OBJECTIVES: To evaluate the safety and efficacy of epilepsy surgery in children and adolescence at Comprehensive Epilepsy Center, Phramongkutklao College of Medicine.
MATERIAL AND METHOD: Children and adolescents, who underwent epilepsy surgery at Comprehensive Epilepsy Center, Phramongkutklao College of Medicine were identified from the epilepsy surgery database. The following parameters were evaluated: age at surgery, duration of seizure prior to surgery, presurgical work up, presurgical as well as postsurgical neurological/ seizure status and neuropathology (if applicable). All follow-up data were obtained through clinic visits.
RESULTS: Fifteen children who underwent epilepsy surgery between January 1, 2003 and March 31, 2005 were identified. Age at surgery ranged from 2.5 years to 19 years (mean age=8.2 years). Seizure duration prior to surgery ranged from 1 year to 17 years (mean=4.7 years). Eight patients (53%) had partial seizures and underwent excisional procedures [5 temporal lobectomy, 2 left frontal corticectomy, and 1 left functional hemispherectomy]. Seven patients (47%) had generalized seizures and underwent anterior 2/3 corpus callosotomy. Pathological information was available for all 8 cases with partial epilepsy. Four out of eight cases with pathological information demonstrated cortical dysplasia, four revealed hippocampal sclerosis, and two patients had dysembryoplastic neuroepithelial tumor (DNET). At follow-up, all 5 patients with temporal lobectomy and a child who underwent functional hemispherectomy were seizure free (follow up period 3-31 months). Two children with extratemporal resective surgery [left frontal corticectomy] showed remarkable improvement with rare breakthrough seizures (follow up period= 3 and 19 months respectively). Four out of seven patients with corpus collosotomy had worthwhile improvement of seizures (follow up period=4-19 months), while another two children were seizure free during short-termed follow up postoperatively (follow up period=1 and 2 months). All patients did not have significant neurological deterioration or worsening of seizure after the surgery.
CONCLUSION: Resective epilepsy surgery in Thai pediatric populations in the authors' experience seems to be safe and effective in selected patients. Most children who underwent callosotomy had a significant reduction in intensity and frequency of tonic, atonic, and tonic-clonic seizures. Dual pathology was common in refractory temporal lobe epilepsy with hippocampal sclerosis. Although the study sample was small, it did advocate several larger studies with the same findings.|
|Description: ||Chotmaihet Thangphaet.|
|Source URI: ||http://www.mat.or.th/journal/all.php|
|Appears in Collections:||Journal of the Medical Association of Thailand|
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