Abstracts

In Göteborg the epilepsy surgery programme started in 1987. In Sweden healthcare is publicly financed with a population-based referral system for specialist care. Göteborg is the referral centre in western Sweden with a population of 1.7 million inhabitants. Epilepsy surgery is thus part of the general healthcare system. This is an outcome study of the total pediatric series of the Göteborg epilepsy surgery programme up to 2002. The children were followed prospectively; outcome data are presented at two years following surgery. All children operated for pharmocoresistant epilepsy during the period 1987 up to the end of 2002 in Göteborg are included. 114 surgical procedures were performed in 96 children. 47% of the children had an IQ [gt]70, 31% had IQ 50-70 and 22% had IQ [lt] 50. 57% of the children were reported to have some type of neurological handicap, 24 % had a cerebral paresis of any degree. Of the 36 patients who underwent temporal lobe resection, 58% became seizure free, and 22% had a [gt] 75% reduction of seizure frequency. Of the 25 patients who underwent extra-temporal single lobe resections, 48 % became seizure free and 28 % had [gt] 75% reduction of seizure frequency. A complete hemispherectomy was performed in 12 children, 75% became seizure free, and another 8 % (n=1) had[gt] 75% reduction of seizure frequency. Two children underwent subtotal hemispherectomies, one had [gt] 75% reduction of seizure frequency, and one had no benefit. Extensive multilobar resections were performed in 13 children, 46% became seizure free, and another 23% had [gt] 75% reduction of seizure frequency. In 13 patients a callosotomy was performed, only one became seizure free, one had [gt] 75 % reduction of seizure frequency. Children with pharmacoresistant epilepsy often have additional problems, such as neurological deficits and/or mental retardation. This population based consecutive pediatric epilepsy surgery series clearly demonstrates that also such a heterogeneous population may have a significant benefit from surgical treatment of epilepsy. (Supported by Margarethahem Foundation.)