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Outcomes of epilepsy surgery in childhood-onset epileptic encephalopathy

Authors
 Yun-Jin Lee  ;  Joon Soo Lee  ;  Hoon-Chul Kang  ;  Dong-Seok Kim  ;  Kyu-Won Shim  ;  Soyong Eom  ;  Heung Dong Kim 
Citation
 Brain & Development, Vol.36(6) : 496-504, 2014 
Journal Title
 Brain & Development 
ISSN
 0387-7604 
Issue Date
2014
MeSH
Adolescent ; Anticonvulsants/therapeutic use ; Brain/pathology ; Brain/surgery* ; Child ; Child, Preschool ; Cognition ; Female ; Follow-Up Studies ; Humans ; Infant ; Intelligence Tests ; Lennox Gastaut Syndrome/complications ; Lennox Gastaut Syndrome/drug therapy ; Lennox Gastaut Syndrome/pathology ; Lennox Gastaut Syndrome/surgery* ; Longitudinal Studies ; Male ; Malformations of Cortical Development/complications ; Malformations of Cortical Development/pathology ; Neuropsychological Tests ; Neurosurgical Procedures ; Spasms, Infantile/complications ; Spasms, Infantile/drug therapy ; Spasms, Infantile/pathology ; Spasms, Infantile/surgery* ; Time Factors ; Treatment Outcome
Keywords
Child ; Cognitive outcome ; Epileptic encephalopathy ; Seizure outcome ; Surgery
Abstract
Purpose: to evaluate the outcomes and role of epilepsy surgery in children with intractable epileptic encephalopathy (EE). Methods: ninety-five children (64 boys, 31 girls) with intractable EE were treated by epilepsy surgery at Severance Children’s Hospital from 2003 to 2008. Surgical treatments included lobar resection, hemispherotomy and corpus callosotomy (CC). Seventy-six children were Lennox–Gastaut syndrome (LGS), and 19 had West syndrome. Results: of the 76 patients with LGS, CC was performed in 37 patients (48.7%), lobar resection in 29 (38.2%) and hemispherotomy in 10 (13.2%). Of the 19 patients with West syndrome, respective surgery was performed in 15 patients (78.9%) and CC in 4 (21.1%). Of the patients receiving respective surgery, Engel’s class I outcomes were achieved for 24 of 39 (61.5%) of LGS patients, and for 9 of 15 (60.0%) of West syndrome. Malformations of cortical development were commonly observed, appearing in 73.5% (36/49). In neuropsychiatric tests, 19 of 27 with LGS demonstrated improvement in postoperative cognitive function. More significant intellectual improvement correlated well with shorter epilepsy duration, good seizure outcomes, and decreased number of antiepileptic drugs. Conclusions: epilepsy surgery should be considered in treating childhood intractable EE with expectation of improvement of both seizure and cognitive outcomes, even in cases of LGS.
Full Text
http://www.sciencedirect.com/science/article/pii/S0387760413002015
DOI
10.1016/j.braindev.2013.06.010
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Hoon Chul(강훈철) ORCID logo https://orcid.org/0000-0002-3659-8847
Kim, Dong Seok(김동석)
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
Eom, So Yong(엄소용)
Lee, Joon Soo(이준수) ORCID logo https://orcid.org/0000-0001-9036-9343
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98876
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