Early Epilepsy Surgery Helps Child Development
Preschoolers See Long-Term Improvement After Seizure Surgery
The first thing to try is medication, Barkley and Helmers say.
"When you have uncontrolled seizures, with every additional drug there is chance of being seizure-free," Barkley says. "That's a good reason to try drugs you haven't tried before. But after a reasonable trial of a few drugs, it is time to think seriously about surgery. And in kids it is even more urgent. Because if you do it today rather than wait two or three years, you keep your child from falling farther behind."
Barkley recommends that parents make the decision whether or not to have surgery within two or three years of epilepsy onset.
Even then, not every child should have surgery. It's necessary to pinpoint the affected area of the brain and to make sure that this area of the brain does not control crucial mental or physical functions.
"The evaluation is quite extensive, so we know not only how to take out that section of brain but how to leave that portion of the brain that is important for language, memory, and so on," Helmers says.
The long-term results, Freitag and Tuxhorn report, can be impressive. After surgery, four out of five kids in their study resumed mental and social development. Nearly three-fourths of the kids continued to improve. This occurred even in kids who were retarded prior to surgery. One out of five kids gained at least 15 IQ points after surgery.
"There is a lot to lose in kids who continue to have seizures," Helmers says. "This study shows we should think of epilepsy surgery sooner rather than later because of improved outcome in these children."
Both Helmers and Barkley warn that epilepsy surgery is a complicated procedure. They recommend that parents considering surgery consult a qualified epilepsy center.