Most appropriate timing for performing pediatric epilepsy surgery

Abstract

Epilepsy surgery should be aggressively considered for the cases of drug-resistant intractable epilepsy, especially earlier in infant and child because persistent epileptic seizures adversely affect on their psychomotor development. To achieve postoperative seizure free, it is required to identify epileptogenic zone and resect epileptic focus completely. Although radical resection of epileptic focus located on eloquent area possibly cause severe neurological complications, relatively good neurological outcomes can be expected because of neural plasticity of childhood brain. Furthermore, it is another reason for deciding surgical indication that long-term administration of anti-epileptic drug causes unfavorable effects on cognitive function of children. On the other hand, the surgical impacts on post-surgical intelligent quotient or coexisting neuropsychiatric disorders are still controversial. Here, we present the most appropriate timing for performing pediatric epilepsy surgery, showing our own clinical examples and literature considerations.