Epilepsy surgery in infancy: A review of four cases

It has been demonstrated that intractable seizures in children can be eliminated or become more responsive to anticonvulsant medication after surgical resection of the epileptogenic focus or dysfunctional hemisphere. We describe our surgical experience with 4 infants treated at Children's Healthcare of Atlanta Egleston Hospital between 1994 and 2002. All infants, ranging in age from 5 to 9 months, presented with severe seizure disorders and failed trials of anticonvulsants. All had preoperative EEG monitoring and MRI studies; 2 had PET functional imaging. One infant underwent a temporal resection for a low-grade glioma. The rest had cortical resections for malformations and dysplasia. All had improvement, with 2 infants free of seizures off medication. We argue for early intervention in severe cases, as the potential for recovery can be dramatic.