Selection and evaluation of children for epilepsy surgery

Major determinants of the success of epilepsy surgery are the proper selection and evaluation of the patient. Candidates should have medically intractable, disabling epilepsy. The evaluation requires a unified, systematic approach by a comprehensive team of health professionals. Key points, common to most evaluations, are enumerated and provide a useful tool for mental organization. In general, the greater the degree of congruent information derived from these investigations, the better the candidacy for surgery. After this, completeness of resection and etiology are other important predictors of success. Children present unique challenges and opportunities owing to the vulnerability and plasticity of the developing nervous system. Surgery for intractable epilepsy can be a rewarding therapy, and in select children, the only chance for cure and substantial development progress.