Approach to pediatric epilepsy surgery: State of the art, Part I: General principles and presurgical workup

摘要: In 1990, the National Institute of Health adopted epilepsy surgery in children as an option when medications fail. past few years several concepts have become increasingly recognized key to a successful approach children. These include neuronal plasticity, epileptogenic lesion, ictal onset, symptomatogenic, irritative, and zones. addition, techniques been utilized delineate above areas attempt determine, each patient, zone, defined zone resection which leads seizure freedom. When semiology (which defines symptomatogenic zone), EEG identifies onset structural imaging lesion) can be reconciled infer location is usually, subsequently, undertaken. these diagnostic modalities are discordant, not definitive, or close eloquent cortex, invasive EEG, complemented by other may needed. magnetoencephalography, single photon emission tomography, various types positron magnetic resonance (functional, diffusion weighted, other) emerging experimental techniques. While MRI, video-EEG, neuropsychological assessments well established components presurgical evaluation, use new technologies dictated degree anatomo-electro-clinical correlations, and, awaiting multicentric studies more detailed guidelines, remains center-dependent.