Pediatric Epilepsy Surgery (cont.)
How is epilepsy treated?
The main line of treatment is with antiepileptic drugs,
which are effective in controlling seizures in 70%-80% of patients with epilepsy.
There are several antiepileptic medications. Since certain medications are much
better for some seizures, the choice of the medication should be made by a
physician who is familiar with these medications. If possible, the child should
be evaluated in a center specializing in epilepsy. If this is not feasible,
usually pediatric neurologists have training in epileptic disorders and are a
good source for a referral.
When antiepileptic drugs fail to control the seizures, the patients may
improve with surgical procedures.
Who is a candidate for epilepsy surgery?
Surgery is indicated in a small group of children.
It usually takes the failure of two or three
antiepileptic medications before a child would be considered as a potential
candidate for surgery. In general, this happens at least after two or three
years of continuous treatment with medications. The failure might be due:
- to a
resistance to the antiepileptic
medications that are available,
- to the presence of intolerable side effects to
the antiepileptic medication,
- or to a combination of both.
Since surgical
procedures might be very effective in some children, once it is clear that the
child's epileptic disorder is not responding to treatment with antiepileptic
medications, surgery should be considered. Young age is not a contraindication
for surgery, and there is no benefit in waiting for the child to be older. In
fact, there is considerable evidence that the younger a child is at the time of
surgery, the better his/her potential will be for good function after the
surgery. There is a certain degree of plasticity in the brain that helps with
the recovery of functions that can be damaged at the time of surgery. This
plasticity is higher in younger than in older children.
Next: What tests are used to determine if a child is a candidate for epilepsy
surgery? »
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