Some conditions are likely to be drug-resistant by their very nature. This means that drug-resistance will be obvious very early in most cases. These drug-resistant conditions include:

Electrical Status Epilepticus in Sleep (ESES)

Hemimegalencephaly

Hypothalmic Hamartoma

Pediatric Stroke

Cortical Dysplasia

Polymicrogyria

Rasmussen’s Encephalitis

 

 

No longer should surgery be considered a last resort in the management of children with focal epilepsy resistant to medication. Drug resistance should be apparent early in the natural history of the epilepsy and, therefore, children should be referred early. Much can be gained from early referral and assessment, even if surgery is not an option. Much can be lost by waiting.

Helen Cross, MD, Epilepsy surgery in children – no longer a last resort.