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Resective pediatric epilepsy surgery in Lennox-Gastaut syndrome

 Yun Jin Lee  ;  Hoon-Chul Kang  ;  Joon Soo Lee  ;  Shin Hye Kim  ;  Dong-Seok Kim  ;  Kyu-Won Shim  ;  Yun-Ho Lee  ;  Tae Seung Kim  ;  Heung Dong Kim 
 PEDIATRICS, Vol.125(1) : 58-66, 2010 
Journal Title
Issue Date
Adolescent ; Cerebral Cortex/abnormalities* ; Cerebral Cortex/surgery ; Child ; Child, Preschool ; Cognition Disorders/diagnosis ; Cognition Disorders/surgery ; Cohort Studies ; Electroencephalography/methods ; Epilepsy, Generalized/diagnosis* ; Epilepsy, Generalized/mortality ; Epilepsy, Generalized/surgery* ; Female ; Follow-Up Studies ; Humans ; Infant ; Magnetic Resonance Imaging/methods ; Male ; NeurosurgicalProcedures/methods* ; Patient Selection ; Preoperative Care/methods ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Survival Rate ; Syndrome ; Treatment Outcome
Lennox-Gastaut syndrome ; epilepsy surgery
OBJECTIVE: The objective of this study was to evaluate the role of resective pediatric epilepsy surgery for Lennox-Gastaut syndrome (LGS).

METHODS: We analyzed clinical data of 27 children and adolescents who had LGS and underwent resective epilepsy surgery despite abundant (>30% of preoperative interictal and/or ictal epileptiform discharges) generalized or generalized contralateral maximal and multiregional electroencephalogram abnormalities.

RESULTS: On high-resolution MRI, cerebral lesions were noted in 23 (85.2%) patients but not in 4 (14.8%) patients. The age of patients at the time of surgery was between 1.7 and 17.3 years (mean: 7.8 years). Surgeries were lobar or multilobar resection in 21 (77.8%) patients and hemispherotomy in 6 (22.2%). At a mean of 33.1 months' postoperative follow-up, 16 (59.3%) patients had no seizures and 4 (14.8%) had infrequent seizures. Of 4 patients without brain abnormalities found on MRI, 2 patients became seizure-free after resective surgery was performed on the basis of electrophysiologic studies and concordant results in other multimodal neuroimages. Malformation of cortical development was the most common pathology and was seen in 20 (74.1%) patients, but 2 (7.4% patients) did not show any abnormal pathology. Sixteen (72.7%) patients, including 14 who had no seizures and 2 who had infrequent seizures after surgery, showed an increase in developmental quotient. No clinical profile was significantly associated with postoperative seizure-free rate.

CONCLUSIONS: Resective epilepsy surgery should be considered for children with LGS, despite abundant generalized and multiregional electroencephalogram abnormalities.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Hoon Chul(강훈철) ORCID logo https://orcid.org/0000-0002-3659-8847
Kim, Dong Seok(김동석)
Kim, Tai Seung(김태승)
Kim, Heung Dong(김흥동) ORCID logo https://orcid.org/0000-0002-8031-7336
Shim, Kyu Won(심규원) ORCID logo https://orcid.org/0000-0002-9441-7354
Lee, Yun Jin(이윤진)
Lee, Yun Ho(이윤호)
Lee, Joon Soo(이준수) ORCID logo https://orcid.org/0000-0001-9036-9343
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