Pediatric Epilepsy Surgery Techniques. Controversies and Evidence

Table of Contents

1. Evidence in Pediatric Epilepsy Surgery
2. Ethical considerations in contemporary Pediatric Epilepsy Surgery
3. Controversies in timing of pediatric epilepsy surgery is earlier better?Invasive Investigation
4. Electrocorticographic evaluation of epileptogenicity Traditional vs novel biomarkers to guide surgery
5. Invasive Monitoring stereoelectroencephalography (SEEG) vs. subdural electrode (SDE) evaluation vs hybrid evaluation Resective or ablative surgery
6. Intra-operative adjuncts to optimize the surgical treatment of drug-resistant epilepsy Do new tools improve outcome?
7. medial Temporal lobe Epilepsy (TLE) - selective amygdalohippocampectomy (SAH) vs. anterior temporal lobectomy (ATL)
8. Epilepsy in eloquent cortex- Resection vs. responsive neurostimulation (RNS)
9. Lesional Epilepsy Lesionectomy vs. ECoG-guided resection
10. Insular/peri-Sylvian Epilepsy Resection vs. Stereotactic ablation (MR-guided laser ablation/Radiofrequency ablation)
11. Hypothalamic Hamartoma Stereotactic radiosurgery (SRS) v. Stereotactic ablation (MR-guided laser ablation/Radiofrequency ablation) v. MRFUS
12. Tuberous Sclerosis Complex Lesionectomy vs lesionectomy plusDisconnective Procedures
13. Functional hemispherotomy Vertical vs. Lateral approach
14. Minimally Invasive Hemispherotomy Endoscopic Assisted vs. Radiofrequency Disconnection
15. Lobar/Multi-lobar epilepsy Resection vs. Disconnection
16. Lennox-Gastaut Syndrome Callosotomy vs. Vagal nerve stimulation (VNS)
17. Corpus Callosotomy Ant 2/3rd (2-stage) v. Complete (1-stage)Neuromodulation
18. TLE with preserved function: Multiple hippocampal transection (MHT) vs. Neuromodulation (DBS, RNS)
19. Neuromodulation Neuromodulation vs 'resective', VNS vs. DBS (TSC, LGS, etc)???????

Authors

Aria Fallah paediatric neurosurgeon at UCLA Mattel Children's Hospital. He is the Director of Pediatric Neurosurgery at UCLA Mattel Children's Hospital and an Assistant Professor of Neurosurgery, and Pediatrics at the David Geffen School of Medicine at UCLA as well as an Assistant Professor in Health Policy & Management in the UCLA Fielding School of Public Health.. Dr. Fallah is a paediatric neurosurgeon at UCLA Mattel Children's Hospital. He is the Director of Pediatric Neurosurgery at UCLA Mattel Children's Hospital and an Assistant Professor of Neurosurgery, and Pediatrics at the David Geffen School of Medicine at UCLA as well as an Assistant Professor in Health Policy & Management in the UCLA Fielding School of Public Health.? He is also a member of the Brain Research Institute at UCLA. His clinical practice is devoted to the surgical management of children with medically intractable epilepsy.? His research mission is to establish high-quality clinical evidence to use towards the development of guidelines and decision-making tools that can standardize decisions and improve the surgical care to treat childhood medically refractory epilepsy.?Dr. Fallah is the lead author of several multi-center studies focused on pediatric epilepsy surgery and serves as a professional advisory board member of the Tuberous Sclerosis Alliance and a Regulatory Advisory Board Member of the Global Pediatric Epilepsy Surgery Registry. George M. Ibrahim Paediatric Neurosurgeon, The Hospital for Sick Children (SickKids); Assistant Professor?in?Biomedical Engineering, Institute of Medical Sciences; Department of Surgery, University of Toronto, Canada. Dr. George Ibrahim is the Abe Bresver Chair in Functional Neurosurgery at the Hospital for Sick Children and Associate Professor in Surgery, Biomedical Engineering and Medical Science at the University of Toronto. He is a Scientist in the Program in Neuroscience and Mental Health at the Hospital for Sick Children Research Institute. He is the Surgical Director of the pediatric DBS program. Alexander G. Weil Paediatric Neurosurgeon, Sainte-Justine University Hospital; Assistant Professor, Department of Surgery and Neuroscience, University of Montreal, Canada. Dr. Weil is a paediatric neurosurgeon at Sainte-Justine University Hospital and an Assistant Professor?in?both the Department of Surgery and Neuroscience at the University of Montreal. He is also a?Surgeon-Scientist in the Brain and Child Development Axis?at?the CHU Sainte-Justine Research Institute. He leads a robust pediatric epilepsy surgery program at the Sainte-Justine University Hospital where he provides surgical treatment of medically intractable epilepsy in children. His clinical and research interests focus on reducing morbidity associated with pediatric epilepsy surgery through novel surgical approaches and evidence-based medicine. Dr. Weil is the co-principal investigator of several ongoing multi-center studies focused on comparing surgical approaches in pediatric epilepsy surgery.