A new study published in Epilepsia reveals surgery for babies and toddlers suffering from epilepsy is relatively safe and is effective in controlling seizures. The findings also show that early surgery may have a positive impact on babies’ brain development.

The study reviews epilepsy surgeries in children under three years of age across all pediatric neurosurgical centers in Canada between 1987 and 2005. 116 children had epilepsy surgeries in 8 centers across Canada. 82 percent of these children started to suffer seizures in their first year of life.

The children generally underwent major brain operations, including removal of or disconnection of half of the brain. Despite such large operations, there were few complications and only one death. At the time of surgery, children were having an average of 21 seizures per day, with one child having as many as 600 seizures per day. One year after surgery, 67.3 percent were seizure free, 14 percent had a greater than 90 percent improvement in seizures. Only 7.5 percent did not benefit from surgery. Development improved in 55.3 percent of the children after surgery.

“The results of this study lead us to conclude that epilepsy surgery in children under three years is relatively safe and is effective in controlling seizures,” says Dr. Paul Steinbok of British Columbia’s Children’s Hospital and the University of British Columbia, lead author of the study. “Thus, very young age is not a contraindication to surgery in children with epilepsy that is difficult to control with medications.”

A large percentage of infants and young children who might benefit from epilepsy surgery are not undergoing the procedure. Currently, such children are often treated ineffectively with various anti-seizure medications on the assumption that surgery should be considered a treatment of last resort. The results of this study argue that surgery may be a better option than continuing drug management and should be considered earlier in the treatment process than is typically done.

Dr. Paul Steinbok is a professor at British Columbia’s Children’s Hospital and the University of British Columbia. He can be reached for questions at .(JavaScript must be enabled to view this email address).

Epilepsia is the leading, most authoritative source for current clinical and research results on all aspects of epilepsy. As the journal of the International League Against Epilepsy, subscribers every month will review scientific evidence and clinical methodology in: clinical neurology, neurophysiology, molecular biology, neuroimaging, neurochemistry, neurosurgery, pharmacology, neuroepidemiology, and therapeutic trials.

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