Resective pediatric epilepsy surgery in Lennox-Gastaut syndrome

Yun Jin Lee, Hoon Chul Kang, Joon Soo Lee, Shin Hye Kim, Dong Seok Kim, Kyu Won Shim, Yun Ho Lee, Tae Seung Kim, Heung Dong Kim

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Abstract

OBJECTIVE: The objective of this study was to evaluate the role of resective pediatric epilepsy surgery for Lennox-Gastaut syndrome (LGS). METHODS: We analyzed clinical data of 27 children and adolescents who had LGS and underwent resective epilepsy surgery despite abundant (>30% of preoperative interictal and/or ictal epileptiform discharges) generalized or generalized contralateral maximal and multiregional electroencephalogram abnormalities. RESULTS: On high-resolution MRI, cerebral lesions were noted in 23 (85.2%) patients but not in 4 (14.8%) patients. The age of patients at the time of surgery was between 1.7 and 17.3 years (mean: 7.8 years). Surgeries were lobar or multilobar resection in 21 (77.8%) patients and hemispherotomy in 6 (22.2%). At a mean of 33.1 months' postoperative follow-up, 16 (59.3%) patients had no seizures and 4 (14.8%) had infrequent seizures. Of 4 patients without brain abnormalities found on MRI, 2 patients became seizure-free after resective surgery was performed on the basis of electrophysiologic studies and concordant results in other multimodal neuroimages. Malformation of cortical development was the most common pathology and was seen in 20 (74.1%) patients, but 2 (7.4% patients) did not show any abnormal pathology. Sixteen (72.7%) patients, including 14 who had no seizures and 2 who had infrequent seizures after surgery, showed an increase in developmental quotient. No clinical profile was significantly associated with postoperative seizure-free rate. CONCLUSIONS: Resective epilepsy surgery should be considered for children with LGS, despite abundant generalized and multiregional electroencephalogram abnormalities.

Original languageEnglish
Pages (from-to)e58-e66
JournalPediatrics
Volume125
Issue number1
DOIs
Publication statusPublished - 2010 Jan 1

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All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

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Lee, Y. J., Kang, H. C., Lee, J. S., Kim, S. H., Kim, D. S., Shim, K. W., Lee, Y. H., Kim, T. S., & Kim, H. D. (2010). Resective pediatric epilepsy surgery in Lennox-Gastaut syndrome. Pediatrics, 125(1), e58-e66. https://doi.org/10.1542/peds.2009-0566