Shields Lisa B, Mutchnick Ian S, Davis Shannon D, Duvall-Howard Brandy, Stambaugh Annette A, Kenney Jennifer, Howard Bronson L, Lamb Kathy, Puri Vinay, Karakas Cemal
Neurological Surgery, Norton Neuroscience Institute, Norton Healthcare, Louisville, USA.
Neurosurgery, Norton Children's Hospital, Louisville, USA.
Cureus. 2025 Aug 15;17(8):e90174. doi: 10.7759/cureus.90174. eCollection 2025 Aug.
Children with epilepsy commonly develop drug-resistant epilepsy, which often necessitates surgical intervention. Timely access to surgical intervention is critical for optimizing outcomes in these children. However, the significant undersupply of qualified epilepsy centers ensures that there remains a pressing need to expand and support pediatric epilepsy centers. This perspective article presents the development and expansion of our Pediatric Epilepsy Surgery Program in Kentucky. Overcoming initial obstacles such as limited infrastructure, staffing, and resources allowed us to implement strategic planning, acquire advanced neurosurgical and neurodiagnostic equipment, increase staff training, and establish subspecialty pediatric epilepsy clinics. Our program boasts several innovative technologies, including Visualase laser ablation, the Surgical Theater 3D visualization platform, responsive neurostimulation, deep brain stimulation, and robotic-assisted stereoelectroencephalography. Since its inception, our program has seen a substantial increase in surgical volume and has attained national recognition for its comprehensive and cutting-edge approach to pediatric epilepsy care. This article aims to describe the strategic development, infrastructure planning, staffing, clinical implementation, and outcomes of a pediatric epilepsy surgery program in a low-resource setting, offering a model for replication. This paper outlines the key steps involved in developing and expanding our Pediatric Epilepsy Surgery Program, which may serve as a valuable model for other institutions seeking to establish or grow their own pediatric epilepsy surgery programs, particularly in regions with limited access to comprehensive epilepsy care.
癫痫患儿常发展为药物难治性癫痫，这往往需要手术干预。及时获得手术干预对于优化这些患儿的治疗结果至关重要。然而，合格癫痫中心的严重供应不足表明，迫切需要扩大和支持儿科癫痫中心。这篇观点文章介绍了我们在肯塔基州的儿科癫痫手术项目的发展与扩张情况。克服了诸如基础设施、人员配备和资源有限等初始障碍后，我们得以实施战略规划、购置先进的神经外科和神经诊断设备、增加人员培训，并设立儿科癫痫专科诊所。我们的项目拥有多项创新技术，包括Visualase激光消融术、外科手术3D可视化平台、反应性神经刺激、深部脑刺激以及机器人辅助立体脑电图。自成立以来，我们的项目手术量大幅增加，并因其全面且前沿的儿科癫痫治疗方法而获得全国认可。本文旨在描述资源匮乏地区儿科癫痫手术项目的战略发展、基础设施规划、人员配备、临床实施及成果，提供一个可复制的模式。本文概述了我们发展和扩张儿科癫痫手术项目所涉及的关键步骤，这对于其他寻求建立或发展自身儿科癫痫手术项目的机构，尤其是在获得全面癫痫治疗机会有限的地区，可能是一个有价值的模式。
