Lesionectomy in the pediatric age.

INTRODUCTION

Due to the development of electrophysiological recordings and the advancement in neuroimaging, which has allowed the identification of underlying focal abnormalities, in some patients with partial seizures, the surgical removal of such lesions has gained widespread recognition as a treatment modality for medically intractable epilepsy.

DISCUSSION

In patients having a well-defined lesion, a good correlation between clinical and electrophysiological features, suggesting a zone of seizures onset around (or even in) the lesion, is the best guarantee to achieve good seizure control by "lesionectomy". However, other factors correlate with the seizure outcome.

CONCLUSION

The persistency of seizures was found to be significantly associated with the completeness of the resection of the lesion and the preoperative duration of epilepsy, and, in some cases, the de novo brain damage induced by the surgical procedure itself. However, given the benefits of seizure control on the developing brain and the risk of secondary epileptogenesis, early surgery is recommended in children.