Epilepsiechirurgie im Kindes- und Jugendalter

Epilepsy surgery in children and adolescents is an effective procedure, which offers a 70% chance of postoperative freedom from seizures in drug resistant focal epilepsies. The best chance of postoperative seizure freedom is after temporal resections and hemispherectomies, the least in extratemporal and multilobular resections. A single, potentially epileptogenic morphological lesion increases the chance of postoperative seizure freedom, whereas any electrophysiological or morphological sign of bilateral or multifocal aetiology decreases this chance. The plasticity of the young brain allows extensive operative procedures like functional hemispherectomies without significant cognitive impairments. In addition to a reduction of seizure frequency there is a chance to improve the cognitive and possibly the psychosocial prognosis. Mortality and morbidity of epilepsy surgery does not surpass that of medically treated severe epilepsy in a long-term course.