Pediatric Epilepsy Surgery at the Epilepsy Center Linz: Postoperative Seizure Outcome, Prognostic Factors, and Safety

Background/Purpose: Epilepsy is one of the most common neurological disorders in children. Despite advances in drug therapy, a significant proportion of children are still refractory to anticonvulsants. Epilepsy surgery is a safe alternative option for these children.

Methods: In our study, we included all patients of the Linz Epilepsy Center who underwent epilepsy surgery before the age of 18 years. Additionally, we evaluated the prognostic value of the preoperative examinations (ictal/interictal EEG, FDG-PET) and demographic data (epilepsy onset, duration, age at surgery, etiology, side, localization, and preoperative seizure frequency).

Results: We identified 31 patients (16 males/15 women) from our database. The median age at the time of surgery was 11.3 years (+ 5 J, range: 4 M–17.5 J). Patients suffered from epilepsy for a median of 4 years (+ 3.5 J, range: 1 M–15.5 J). Most patients (54.8%) had daily seizures. The most common etiology was focal cortical dysplasia (61.2%), mostly in the frontal lobe (51.6%). Ten patients required EEG with implanted electrodes before surgery. Seizure freedom was achieved in 70.9% of patients. Permanent postoperative deficits were observed in only 6.4%. The observation time ranged up to 18 years. Prognostic value was given by focal results in FDG-PET, ictal EEG, which matched the epileptogenic zone and onset of epilepsy after 1 year of age.

Conclusion: Epilepsy surgery is now established as a therapeutic option in children. It is a safe and promising method in children with difficult-to-treat seizures. The exact identification of the epileptogenic zone by additional examinations is essential for a good postoperative outcome.

Publication History

Article published online:
28 October 2021