Targeted Surgery Can Benefit Children with Medically Refractory Epilepsy | Physicians Update | UCLA Health

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Epilepsy STORY HIGHLIGHTS At least three-fourths of the children referred to UCLA’s Pediatric Epilepsy Surgery Program can be made completely or nearly seizure-free. Among children with epilepsy, 60-to-70 percent will have their seizures controlled on drug treatment. Frequent seizures from medically refractory epilepsy are strongly linked to significant developmental delay that is generally not reversible, and they also are associated with premature death. Targeted Surgery Can Benefit Children with Medically Refractory Epilepsy The danger of uncontrolled seizures in infants and children over any period of time — including the likelihood of poor long-term developmental outcomes and the risk of premature mortality — makes it essential that pediatric patients whose seizures cannot be controlled by medication are promptly referred to a center that specializes in pediatric epilepsy. Gary Mathern, MD, director of UCLA’s Pediatric Epilepsy Surgery Program, notes that not all patients referred to his program are recommended for surgery — but for those who are, at least three-fourths can be made completely or nearly seizure-free. How is epilepsy defined, and what proportion of epilepsy cases can be controlled by medication? Epilepsy is commonly defined as having two or more unprovoked seizures separated by at least 24 hours. The rate of newly diagnosed seizures for those under age 15 is about 500 cases per 1-million children per year. Of these, about 70 percent are controlled or nearly controlled by anti-epilepsy drugs. Of the remaining 30 percent of children with epilepsy, about half have more than a seizure per month. About 15 percent of children with epilepsy are medically refractory, Gary Mathern, MD UCLAHEALTH.ORG 1-800-UCLA-888 (1-800-825-2888) which is defined as failure of two-to-three anti-epilepsy drugs and with frequent-enough seizures that they affect the child’s life. Of those with medically refractory epilepsy, about one-third are candidates for epilepsy surgery. Has drug therapy for epilepsy improved? There have been anti-epilepsy drugs around since the 1940s, and there has been an explosion of drugs that have been approved since the 1990s. The new drugs have reduced the side effects, but the bottom line is that the incidence of medically refractory epilepsy has not changed.