Navigation Links
Good outcomes with staged surgery for epilepsy in children
Date:1/27/2014

Philadelphia, Pa. (January 27, 2014) A staged approach to epilepsy surgerywith invasive brain monitoring followed by surgery in a single hospital stayis a safe and beneficial approach to treatment for complex cases of epilepsy in children, reports the February issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"Staged epilepsy surgery with invasive electrode monitoring is safe in children with poorly localized medically refractory epilepsy," write Drs. Jonathan Roth and Howard Weiner of NYU Langone Medical Center, New York City, New York. Their 13-year review suggests that complication rates decrease further as surgeons gain experience with staged epilepsy surgery.

Staged Surgery for the Most Complex Cases of Childhood Epilepsy

From 1996 to 2009, the researchers performed staged surgery in 161 children with refractory epilepsy that could not be controlled with anti-seizure medications. The children averaged about seven years old. Most had "multifocal" epilepsy originating from more than one area of the brain, often related to a genetic condition called tuberous sclerosis complex.

In the staged approach, children underwent two or more surgical procedures for epilepsy during one hospital admission. The first step was invasive monitoringsurgery to place electrodes, which were used to map the "epileptogenic" areas of the brain from which seizure activity was originating.

Eighty percent of children subsequently underwent surgery to resect the epileptogenic brain areas. In a total of 200 hospitalizations, the children underwent nearly 500 surgical procedures for invasive monitoring, resection, and electrode removal. Dr. Roth and colleagues write, "Most children underwent only one admission, most of which included two or three surgeries."

The current study focused on the safety of staged epilepsy surgery. Complications occurred at rates expected for children undergoing neurosurgical procedures. This included serious but less-common complications, such as neurologic abnormalities and central nervous system infections; as well as minor complications such as bone absorption or noninfectious fevers. Twenty-five children had complications requiring surgery.

Benefits of Staged Surgeries Outweigh the Risks

"Notably, surgical experience appeared to lower the complication rate," Dr. Roth and coauthors write. Complications decreased from 30 percent during the first six years of the experience, to 15 percent in the last six years. Complication rates were similar in different subgroups of patients, including those with more surgeries or more hospital admissions.

Surgery is an important treatment option for epilepsy that does not respond to medications. However, in some complex cases, the epileptogenic area can't be readily identified or seizures are originating from multiple sites.

The authors' department has previously reported good outcomes with staged surgery for children with complex epilepsy, producing large reductions in seizures for most patients. However, this approach is still not widely used, perhaps reflecting concerns that it might lead to high complication rates.

The new analysis suggests that staged epilepsy surgery in children is "relatively safe," with no higher than expected types and rates of complications. However, "When considering the risk-benefit profile in these children with severe epileptic disorders, we found that the benefits outweigh the risks," Dr. Roth and colleagues write.

They believe the staged surgical approach is especially appropriate, given the high risks of severe and repeated seizures in complex childhood epilepsy. The researchers have no single explanation for the reduction in complications over their 13-year experience, but it may reflect close attention to key technical details and patient care routines.


'/>"/>

Contact: Connie Hughes
Connie.Hughes@wolterskluwer.com
646-674-6348
Wolters Kluwer Health
Source:Eurekalert

Related medicine news :

1. In children born with severe heart defect, surgical management has little effect on neuro outcomes
2. Early treatment improves outcomes in rare, often undiagnosed form of encephalitis
3. Intensivists at night improve patient outcomes in some ICUs, says Pitt/UPMC team
4. Phone contact with nurses linked with better outcomes for women with gestational diabetes
5. Group B streptococcal meningitis has long-term effects on childrens developmental outcomes
6. Hospital volume and surgeon specialty influence patient outcomes
7. MDS researchers join forces to advance patient treatments and outcomes
8. Future reproductive outcomes for women who have had an ectopic pregnancy
9. Obesity, larger waist size associated with better outcomes in heart failure patients
10. ACL reconstruction technique improves outcomes in pediatric patients
11. Newer hip reconstruction technique provides good outcomes for athletes
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/29/2016)... ... April 29, 2016 , ... Our bodies are bombarded daily by environmental and ... with these stressors is to adopt a more healthful diet, but too many people ... a certified Holistic Nutritionist and the creator of the Newport Beach Cleanse and 14-Day ...
(Date:4/29/2016)... ... 29, 2016 , ... The White House announced efforts yesterday ... information about their loan terms and accounts, and more protections for borrowers. The ... and private loans, has reached $1.3 trillion, with 43 million Americans holding student ...
(Date:4/29/2016)... ... ... Spine Team Texas, a comprehensive spine physician group specializing in the treatment of ... invited to be a featured speaker at the Texas Society of the American College ... , Dr. R. Scott McPherson, a physical medicine and rehabilitation specialist, will speak ...
(Date:4/29/2016)... ... April 29, 2016 , ... The ... (CCA), is pleased to announce the launch of the GFCP Scoop ... and more. The purpose of the GFCP Scoop site is to ...
(Date:4/29/2016)... ... 29, 2016 , ... Reltok Nasal Products proudly announces that Boston Medical Products, ... nose and throat specialty, has added the KOTLER NASAL AIRWAY™ to its diverse product ... a newly patented safety device secured by nasal surgeons onto the floor of the ...
Breaking Medicine News(10 mins):
(Date:4/29/2016)... , April 29, 2016  In the ... projected to shift from systems dependent on CRTs monitors ... types of modality CRT Medical monitors and will ... are a host of foreseeable benefits to this ... will existing modalities have to be replaced in ...
(Date:4/29/2016)... , April 29, 2016 ... H1 2016" market research report that provides an ... comparative analysis at various stages, therapeutics assessment by ... administration (RoA) and molecule type, along with latest ... also reviews key players involved in the therapeutic ...
(Date:4/29/2016)... New Jersey , April 29, 2016 /PRNewswire/ ... Software Suite for Life Sciences, Product Development Capabilities ... Global Life Science Customer Base . ... solutions provider, today announced the acquisition of Skura ... a global leader in adaptive sales enablement technology ...
Breaking Medicine Technology: