医学
难治性癫痫
癫痫
癫痫外科
模式
磁共振成像
重症监护医学
小儿癫痫
不利影响
儿科
精神科
放射科
社会科学
内科学
社会学
作者
Fernando Galán,Alexandra D Beier,Raj D. Sheth
标识
DOI:10.1016/j.pediatrneurol.2021.06.004
摘要
A large number of patients have epilepsy that is intractable and adversely affects a child's lifelong experience with addition societal burden that is disabling and expensive. The last two decades have seen a major explosion of new antiseizure medication options. Despite these advances, children with epilepsy continue to have intractable seizures. An option that has been long available but little used is epilepsy surgery to control intractable epilepsy.This article is a review of the literature as well as published opinions.Epilepsy surgery in pediatrics is an underused modality to effectively treat children with epilepsy. Adverse effects of medication should be weighed against risks of surgery as well as risks of nonefficacy.We discuss an approach to selecting the appropriate pediatric patient for consideration, a detailed evaluation including necessary evaluation, and the creation of an algorithm to approach patients with both generalized and focal epilepsy. We then discuss surgical options available including outcome data. New modalities are also addressed including high-frequency ultrasound and co-registration techniques including magnetic resonance imaging-guided laser therapy.
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