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June 01, 2010; 74 (22) Editorials

Pediatric epilepsy surgery

Looking back while moving forward

Elizabeth J. Donner, Howard P. Goodkin
First published May 19, 2010, DOI: https://doi.org/10.1212/WNL.0b013e3181e5043e
Elizabeth J. Donner
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Pediatric epilepsy surgery
Looking back while moving forward
Elizabeth J. Donner, Howard P. Goodkin
Neurology Jun 2010, 74 (22) 1756-1757; DOI: 10.1212/WNL.0b013e3181e5043e

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Nearly a quarter of childhood epilepsy is medically refractory.1 For those children and their families, surgical intervention has the potential to reduce the burden of epilepsy. To address the unique challenges of epilepsy surgery in this population, dedicated multidisciplinary pediatric epilepsy centers have been developed. An expert international consensus panel2 recommended that referral to such centers be considered for all children who are medically refractory or experiencing disabling medication side effects, independent of their cognitive ability or the presence of psychiatric comorbidity.

The success of epilepsy surgery depends on several factors, including the underlying etiology and the ability to obtain a complete resection of the epileptogenic zone.3 It has been assumed that technological advances in structural and functional imaging and electroencephalography will result in an improved ability to identify the epileptogenic zone, and thus improved surgical outcomes over time.

In this issue of Neurology®, Hemb et al.4 test this assumption in a comprehensive, retrospective report of surgical outcomes from the well-established UCLA Pediatric Epilepsy Surgery Program from 1986 through 2008. In this follow-up to a prior publication from …

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