Pediatric Epilepsy Surgery Techniques: Controversies and Evidence offers clinicians a roadmap for navigating the complex decision-making process involved in selecting surgical interventions for children with drug-resistant epilepsy. Over the last decade, the landscape of pediatric epilepsy surgery has undergone substantial transformation, marked by the introduction of several emerging technologies that are now supported by an expanding body of evidence, yet leading to a wide range of treatment practices. This book addresses several decision-making dichotomies in pediatric epilepsy surgery, both in terms of established and novel surgical modalities and techniques. The book explores long-standing debated topics, such as the relative benefits of disconnective compared to resective strategies, the utility of surgical adjuncts like intra-operative electrocorticography, as well as rationales for different surgical approaches, namely selective amygdalo-hippocampectomy versus anteromesial temporal lobectomy. Further, it addresses dichotomies between traditional approaches and contemporary modalities, such as microsurgical resection versus laser interstitial thermal therapy. Chapters also offer comparisons of modern technologies, such as different neuromodulation strategies, including vagus nerve stimulation, deep brain stimulation, and responsive neurostimulation. This book provides readers with the relevant scientific literature and expert commentary to inform evidence-based approaches to surgical care in pediatric drug-resistant epilepsy.
Table of Contents
Part 1: Evidence in pediatric epilepsy surgery1. Evidence in pediatric epilepsy surgery
Churl-Su Kwon and Varun Ramanan Subramaniam
2. Controversies in the timing of pediatric epilepsy surgery-is earlier better?
Jarod L. Roland
Part 2: Invasive investigation
3. Electroencephalographic evaluation of epileptogenicity-traditional versus novel biomarkers to guide surgery
Eroshini Swarnalingam and Julia Jacobs
4. Invasive monitoring: stereoelectroencephalography (sEEG) versus subdural electrode (SDE) versus hybrid evaluation
Taylor J. Abel, Luis Fernandez and Joseph Garcia
Part 3: Resective or ablative surgery
5. Intraoperative adjuncts to optimize the surgical treatment of drug-resistant epilepsy-do new tools improve outcome?
Trang Tran, Frederic Leblond and Roy W.R. Dudley
6. Medial temporal lobe epilepsy-selective amygdalohippocampectomy versus anterior temporal lobectomy
Christian Dorfer
7. Epilepsy in eloquent cortex: resection versus responsive neurostimulation
Saadi Ghatan
8. Lesional epilepsy: lesionectomy versus ECoG-guided resection
Shimrit Sibony-Uliel and Jonathan Roth
9. Insular/perisylvian epilepsy: Open resection versus stereotactic ablation (MR-guided laser ablation/radiofrequency thermocoagulation) versus responsive neurostimulation
Vincent Joris, Jessica Royer and Alexander G. Weil
Part 4: Hypothalamic hamartoma
10. Hypothalamic hamartoma-open surgery versus endoscopic surgery versus stereotactic radiosurgery versus stereotactic ablation (MR-guided laser ablation/Radiofrequency ablation) versus MRFUS
Santiago Candela-Canto, Roberto Martinez Alvarez and Jose Hinojosa Mena-Bernal
Part 5: Tuberous sclerosis complex
11. Resective surgery in tuberous sclerosis complex-related epilepsy: tuberectomy and tuberectomy plus
Shuli Liang, Zhirong Wei, Jiaqi Wang and Feng Zhai
Part 6: Disconnective procedures
12. Functional hemispheric surgery-vertical versus lateral approach
Jia-Shu Chen, H. Westley Phillips and Aria Fallah
13. Minimally invasive hemispherotomy-endoscopic, radiofrequency and robotic techniques
Poodipedi Sarat Chandra and Manjari Tripathi
14. Lobar/multilobar epilepsy: resection versus disconnection
Vejay N. Vakharia and Martin M. Tisdall
15. Corpus callosotomy: anterior two-thirds (two-stage) versus complete (one-stage)
Meena Vessell and Robert J. Bollo
Part 7: Neuromodulation
16. Temporal lobe epilepsy with preserved function: multiple hippocampal transection versus neuromodulation (deep brain stimulation, responsive neurostimulation)
Logan Massman and Sean Lew
17. Neuromodulation: comparison of vagus nerve stimulation, deep brain stimulation, and responsive eurostimulation
Nebras M. Warsi, Hrishikesh Suresh and George M. Ibrahim