October 7, 2021

Surgical Candidates for Pediatric Epileptic Spasms Can Be Selected Without Invasive Monitoring

Abstract, originally published in Epilepsy Research

Selecting children with epileptic spasms for surgery based on the location and extent of lesions detected on brain MRI, nearby eloquent regions and preexisting deficits yields seizure-free results comparable to a strategy that includes intracranial monitoring. This MRI-based approach not only reduces risk by avoiding an invasive procedure but allows surgery to be conducted more promptly. So concludes a study — recently published in Epilepsy Research — of a large series of children who underwent surgery for epileptic spasms without invasive monitoring.

“In prior surgical series of children with epileptic spasms, invasive intracranial EEG monitoring has been used in 20% to 65% of patients,” says the study’s corresponding author, Ahsan N.V. Moosa, MD, a Cleveland Clinic pediatric epileptologist. “At Cleveland Clinic, almost all children who have epileptic spasms with an epileptogenic lesion on MRI undergo surgery without invasive intracranial EEG monitoring. This series confirms that this approach is sound.”

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