Newswise – Epilepsy surgery in infants under 3 months of age is safe and effective, according to multinational, multicenter study published in the journal Epilepsy. The study found that surgery can stop seizures and reduce the need for medication in babies with drug-resistant epilepsy and epileptic encephalopathy. The authors caution, however, that surgeries for this age group require a subspecialty team of experts, such as those at some comprehensive pediatric epilepsy centers in tertiary and quaternary pediatric hospitals. These special teams of experts have the experience and resources focused to handle complex and technically challenging surgeries on the youngest and the smallest children.
Surgery for newborn epilepsy is rare. This type of surgery can represent a major surgical intervention with associated surgical and anesthetic risks in young patients. To reduce these risks, epilepsy surgery has traditionally been postponed until the child is older. However, living with epilepsy as a young baby comes with its own serious risks due to the impact of seizures and medications on neurodevelopment. In this study, the authors show the positive safety profile of surgery for ultra-early epilepsy in experienced tertiary centers. Together, this consortium of pediatric neurosurgeons is showing that there is no need to wait: surgery for epilepsy in young babies can be performed safely and effectively.
“We know that exposure of babies to ongoing seizures and the side effects of anti-epileptic drugs can be very detrimental to brain development,” said co-author Sandi Lam, MD, MBA, division head of neurosurgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and professor of neurological surgery at Northwestern University Feinberg School of Medicine. “Our study found that in order to stop seizures and give newborns a chance to reach their full potential, surgery should not be delayed, as long as it is performed in one of the few centers in the world capable of ‘offer this type of complex procedure. without issue. Lurie Children’s is one of those specialized centers with experts equipped to handle such complex cases. Excellent surgical technique, anesthesia care and intensive care are all prerequisites for good results, and at Lurie Children’s we pride ourselves on providing all of this to our youngest patients with intractable epilepsy.
The study included 64 infants who had epilepsy surgery before the age of 3 months, making it the largest series to date. Excellent epilepsy results were obtained in 66% of cases over a median follow-up of 41 months. The number of anti-epileptic drugs has been drastically reduced. The rates of postoperative complications were comparable to those seen in older children.
“Further studies are needed to examine the long-term neurocognitive and neurodevelopmental outcomes of epilepsy surgery in newborns,” said Dr. Lam, David G. McLone, MD, PhD chair in pediatric neurosurgery. “In the meantime, our results give hope for a healthier future for these babies.”
Research at the Ann & Robert H. Lurie Children’s Hospital in Chicago is being conducted by the Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving the health of children, transforming pediatric medicine, and securing a healthier future through the relentless pursuit of knowledge. Lurie Children’s is ranked among the best children’s hospitals in the country by American News and World Report. It is the pediatric training ground of Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 220,000 children in 48 states and 49 countries.