Epilepsy Surgery for Cognitive Improvement in Epileptic Encephalopathy

John R McLaren; Kristopher T Kahle; R Mark Richardson; Catherine J Chu

doi:10.1016/j.nec.2023.08.002

Epilepsy Surgery for Cognitive Improvement in Epileptic Encephalopathy

Neurosurg Clin N Am. 2024 Jan;35(1):49-59. doi: 10.1016/j.nec.2023.08.002. Epub 2023 Oct 3.

Authors

John R McLaren¹, Kristopher T Kahle², R Mark Richardson³, Catherine J Chu⁴

Affiliations

¹ Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; Harvard Medical School.
² Harvard Medical School; Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, Wang Building Room 333, Boston, MA 02114, USA.
³ Harvard Medical School; Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, Their Building, 4th Floor, Boston, MA 02114, USA.
⁴ Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; Harvard Medical School. Electronic address: cjchu@mgh.harvard.edu.

PMID: 38000841
PMCID: PMC11384968 (available on 2025-01-01)
DOI: 10.1016/j.nec.2023.08.002

Abstract

Epileptic encephalopathies are defined by the presence of frequent epileptiform activity that causes neurodevelopmental slowing or regression. Here, we review evidence that epilepsy surgery improves neurodevelopment in children with epileptic encephalopathies. We describe an example patient with epileptic encephalopathy without drug refractory seizures, who underwent successful diagnostic and therapeutic surgeries. In patients with epileptic encephalopathy, cognitive improvement alone is a sufficient indication to recommend surgical intervention in experienced centers.

Keywords: CSWS; Case report; Developmental epileptic encephalopathy; ESES; Interictal localization; Neurodevelopment; Outcome; Pediatric epilepsy surgery.

Publication types

Review

MeSH terms

Child
Cognition
Electroencephalography
Epilepsy* / complications
Epilepsy* / surgery
Humans

Grants and funding

R01 NS115868/NS/NINDS NIH HHS/United States