Development of epilepsy surgery in children in Thailand: Experiences in Ramathibodi Hospital

The authors report the experience in treatment of pediatric epilepsy in a referral university hospital located in Bangkok, Thailand. After the reactivation of program of surgical treatment for epilepsy in the Institute in October 2005, seven Thai children under 17 years with intractable epilepsy received surgical treatment. Presurgical evaluation for each patient includes 1.5-tesla magnetic resonance imaging of brain, interictal and ictal EEG recording with video monitoring, and ictal and interictal SPECT. Evaluation of memory is applied to selected case. The surgical treatment includes corpus callosotomy in one patient; cortical resection, anterior temporal lobectomy with amygdalohippocampectomy, and function hemispherectomy in 2 patients each. Pathological findings were glioneural harmatoma, mesial temporal sclerosis, combination of mesial temporal sclerosis and neuronal heterotropia, dysembryoplastic neuroepithelial tumor (DNET), and ganglioglioma. There was no immediate complication or aggravation of seizures observed. Being a preliminary report in small number of patients, conclusion of outcome of treatment is not possible. However, this report represents the effort of the authors in setting up a comprehensive epilepsy program to offer surgical treatment of epilepsy in children in Thailand. The preliminary result is favorable and creates the motivation in rendering the treatment option for children with intractable epilepsy in the country.