Surgical Therapy in Epilepsy

" Epilepsy affects approximately two point five million people in the United States. Which an estimated 300000. Are children under the age of fourteen. Although most children are able to achieve seizure control through the use of anti -- and Medicare and I'm content of what's known we're fracturing or medication resistant epilepsy. These children are unable to gain control through the use of medication. And look to alternative treatments. Want to alternative is brain surgery. Although -- benefits of any surgical procedure need to be discussed thoroughly. Is especially true when it comes to pediatric brain surgery."

" Evaluation procedure for a child being considered for epilepsy surgery is very -- all the information based on the imaging MRI scans functional imaging sensors are scanning like scanning and EG. I'm are all considered all the clinical features and the EG data -- all put together. Are discussed at a comprehensive conference and surgical plan to cut is down derived from that particular child. After that Don we sit down with the family and we discussed the potential risks and benefits -- what we think we'll. Will be expected with a surgical approach and friendly really makes a decision about whether you wanna go ahead. If an agreement to -- surgery will be an official to the child there are a variety of surgical techniques currently being performance. The traditional approaches brain surgery or any -- I mean I'll win the brain is actually remove. Moved the major focus has identified using a variety of techniques and it is can be done safely on the area of your focus is removed safely. They're also techniques and involved -- stimulation -- Commonly known as dangled her stimulation device is implanted around -- nerve in the neck. Attached to a generator and loans and certain current. To do in honor of which has any abroad can con activity with their in the brain and that has not an ability to control -- uses well and there's a procedure called corpus Kallis sodomy which is done in the center of the for the -- Five or bundle that connects right -- the left side of the brain is severed. And that is done to prevent the rapid spread of leisure activity and can really help these attacks and that's all you've done. Moral lessons of -- procedure in children with this type of apple. Pediatric brain surgery perhaps the most effective in children who hit three main criteria. Candidates for pediatric epilepsy surgery children who are number one having seizures that are not controlled by medication. Number you are having problems with their development at a spot to be related to the factory here. That is they're not developing a milestone that has language of motor milestones they're not able to participate fully in school of social situations. And -- have a comprehensive evaluation including imaging MRI scan the brain and -- electoral battleground which shows a focal abnormality that can be removed surgically. As with any surgery safety is a major concern. Apple is charging for children is very income 2005. Overall if you look at the numbers the chance of I'm very adverse complications from your -- seemingly low. -- risk that zero and we sit down with interest and we before we consider going down -- throat and I -- very lengthy discussion about the expected benefits. The potential risks of potential complications. So that everyone is well aware of what we're getting into an Ivy League. You can only consider this type of approach -- none of the benefits far outweigh the risks in the most often those --"

" One of the main reasons that epileptic brain surgery is being used more and more this it's high degree of attractiveness. Or drinker --"

" practice apple he is very attractive on and it really depends on yeah. I'm variety of characteristics. On that the child brings -- table for example. It has a very discreet focus in the brains that we can localized easily. On MRI scanner other imaging modalities and that abnormality -- Loose. You gene which is the electoral unsettled ground that is used to detect seizure activity if that's the case in the success rate of removing that focus is exceedingly high. 90% or block or control procedures. The opposite end of the spectrum means when there's nothing on the MRI scan and the electrical abnormality that is detective on UG's very diffused then we have to be very careful on women in terms of what we can do. So there's a whole spectrum I would say that the success rate for all comers is about two thirds of children in our experience. Are rendered seizure free from epilepsy surgery."

" Surgical therapies for children with epilepsy is an evolving field. And physicians researchers and insurgents are constantly looking for new ways to use surgical methods to help children with epilepsy. "

" Surgical therapy for children with apple has evolved over the years in the stands and has become much more safe. And much more fat in different. Previously and it was this transparent -- was extremely dangerous that it was -- that was encased in. I think many centers around the world have demonstrated that this is anything -- carefully selected children I think there have been tremendous advances and we've only. Touched the tip of the iceberg in terms of children who might benefit."