Epilepsy Surgery in Children in Thailand: Preliminary Result from a Referral Center
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Purpose: To demonstrate the preliminary result of surgical treatment in a university-based hospital in Thailand.Methods: The medical records of children and adolescents who received surgical treatment for epilepsy at Ramathibodi Hospital, Bangkok, Thailand from October 2005 till July 2007 were reviewed.Results: 38 children and adolescents (21 males and 17 females; ages ranged from 14 months to 18 ½ years, mean 9.5 years, median 9.75 years) were included in this study. 18 and 20 were classified into symptomatic and cryptogenic/idiopathic groups, respectively. Lennox-Gastaut syndrome, West syndrome, tuberous sclerosis and Sturge-Weber syndrome were diagnosed in 10, 3, 2 and 1 patients, respectively. Presurgical evaluation consisted of ictal/interictal video-monitored EEG recording, MRI of brain and ictal/interictal SPECT scans. Surgical treatment were lesionectomy, lobectomy, corpus callosotomy, corpus callosotomy with lobectomy, anterior temporal lobectomy with amydalohippocampectomy, functional hemishperectomy and hemispherotomy in 11, 9, 8, 2, 5, 2 and 1 patients, respectively. Follow-up durations ranged from 1 to 19 months. The outcomes were freedom from seizure, significant seizure reduction, minimal seizure reduction, and no frequency change in 22, 11, 3 and 2 patients, respectively. One antiepileptic drug was removed from the treatment regimen in 11 patients. No patient deteriorated after treatment. The majority of parents reported improvement of social interaction and motor functions.Conclusion: Although this is a report of a small number of patients with short follow-up duration, the preliminary result is in favor of surgery as an option for the treatment of childhood and adolescent intractable epilepsy in Thailand.
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