Surgery Successful for Children with Epilepsy

Epilepsy is a more common disorder in children than chickenpox and diabetes. Now, pediatric patients with this neurological disorder may find hope in treatments other than medications.

Two-thirds of carefully selected pediatric patients at Texas Children’s Hospital have experienced a complete elimination or dramatically reduced number of seizures after undergoing surgery.

“Uncontrollable seizures can affect a child’s memory, concentration, motor skills and school performance,” said Angus Wilfong, M.D., director of Texas Children’s Comprehensive Epilepsy Program and assistant professor of pediatrics and neurology at Baylor College of Medicine. “But surgical options can either eliminate or reduce the frequency and severity of seizures.”

One effective surgery is vagus nerve stimulation. A device that connects to the vagus nerve in the neck is surgically implanted in the patient’s chest. The device, similar to a cardiac pacemaker, delivers intervals of electrical signals 24 hours a day to the brain. In addition, when a patient senses an onset of a seizure, he or she can activate the device through a hand-held magnet to deliver an additional dose of stimulation to control the seizure.

Another surgery involves removing the section of the brain where the seizures begin, providing that the portion being removed won’t affect important abilities like speech, memory or vision. Prior to surgery, physicians map where the seizures begin and determine if this region can be safely removed.

“If a child has medically uncontrollable seizures that originate from a focal area of the brain, resective epilepsy surgery should be strongly considered,” said Daniel Yoshor, M.D., neurosurgeon at Texas Children’s Hospital and assistant professor of neurosurgery at Baylor College of Medicine. “Because children’s brains are still developing, they have a unique ability to rebound from these surgeries.”

Childhood epilepsy is similar to adult epilepsy, with a few important differences, Wilfong added. For instance, seizures and the medications used to treat children can have a lasting negative effect on the growing brain. Children with epilepsy also have a slightly increased risk of mental retardation and can develop behavioral and emotional problems due to embarrassment or teasing, making surgery a viable option.

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