Pediatric Epilepsy Surgery

In 1997, Jean AICARDI, one of the most brilliant child neurologists of our era, commented on "How the view has changed" in the field of pediatric epilepsy surgery: "Surgery for epilepsy has now become a realistic therapeutic option for selected children and the field is likely to increase in the near future. It is now realised that procrastination, in the hope that new antiepileptic drugs will become efficacious, is not justified for some forms of epilepsy that can often be recognised from onset or after a relatively short course. It is also becoming clear that surgery is not reserved for a highly selected population of patients with normal intelligence and focal seizures, but may also help a proportion of more severe epilepsies if a realistic view of the problem and perspectives is taken by the partners".

Twenty years later, the most obvious and probably still the strongest reasons against epilepsy surgery in children are cultural and psychological. This book, written by members of the ad hoc ILAE Task Force for pediatric epilepsy surgery and experts in the field, is the result of continued collaborative working between pediatric epilepsy surgery centres over the years. Authors critically review all available data and set out the key elements of presurgical evaluation, the specific electro-clinical presentations per etiology, the range of outcomes to be monitored, and the surgical techniques used today.

What becomes obvious when reviewing all available data is that the key to optimized outcome in children with epilepsy is early appropriate recognition of possible surgical candidates and timely referral to centres with expertise.