Quality of life after epilepsy surgery in children: a systematic review and meta-analysis. Maragkos GA, Geropoulos G, Kechagias K, Ziogas IA, Mylonas KS. Social outcomes after temporal or extratemporal epilepsy surgery: a systematic review. Hamiwka L, Macrodimitris S, Tellez-Zenteno JF, et al. Psychosocial outcomes in children two years after epilepsy surgery: has anything changed? Epilepsia. Do behavior and emotions improve after pediatric epilepsy surgery? A systematic review. Neuropsychological outcomes after epilepsy surgery: systematic review and pooled estimates. Sherman EM, Wiebe S, Fay-McClymont TB, et al. Surgery for drug-resistant epilepsy in children. Seizure freedom improves health-related quality of life after epilepsy surgery in children. Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis. Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. #EPILEPSY GRID MAPPING PROTOCOL TRIAL#A randomized, controlled trial of surgery for temporal-lobe epilepsy. Wiebe S, Blume WT, Girvin JP, Eliasziw M. Definition of drug resistant epilepsy: consensus proposal by the ad hoc task force of the ILAE commission on therapeutic strategies. Remission of epilepsy after 2 drug failures in children: a prospective study. #EPILEPSY GRID MAPPING PROTOCOL UPDATE#Update on the epidemiology and prognosis of pediatric epilepsy. Epidemiology of epilepsy surgery in India. Early identification of refractory epilepsy. The start and development of epilepsy surgery in Europe: a historical review. Schijns OE, Hoogland G, Kubben PL, Koehler PJ. Pediatric DRE should be evaluated early considering the risk of epileptic encephalopathy and negative impact on cognition. DBS and RNS are currently not approved in children. Other surgical procedures, typically considered to be palliative are neuromodulation. Surgical options include resective surgeries (lesionectomy, lobectomy, multilobar resections) and disconnective surgeries (corpus callosotomy, etc.) with the potential to obtain seizure freedom. Selected children may need invasive long-term electroencephalographic monitoring using stereotactically implanted intracranial depth electrodes or subdural grids. Some children may also need functional MRI to map eloquent regions of interest such as motor, sensory, and language functions to avoid unacceptable neurological deficits after surgery. Advanced investigations such as positron emission tomography (PET), single-photon emission computed tomography (SPECT), and magnetoencephalography (MEG) may be required in selected cases especially when brain MRI is normal, and further evidence for anatomo-electro-clinical concordance is necessary to refine candidacy for surgery and surgical strategy. Pre-surgical screening workup typically includes a high-resolution epilepsy protocol brain magnetic resonance imaging (MRI) and a high-quality in-patient video electroencephalography evaluation. A randomized controlled trial provided a class I evidence for epilepsy surgery in pediatric DRE. After failing adequate trials of two appropriate antiseizure drugs, patients with focal DRE or poorly classifiable epilepsy or epileptic encephalopathy with focal electro-clinical features should be worked up for surgical candidacy. Poor compliance and nonepileptic events should be ruled out as possible causes of drug-resistant epilepsy (DRE). However, nearly one-third of patients may be refractory to antiseizure drugs. Epilepsy is a common neurological condition in children.
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