Presurgical evaluation and outcome of epilepsy surgery in childhood

Surgery in the management of children with epilepsy is not new. Murray Falconer, a neurosurgeon at the Maudsley Hospital, recognised that children as well as adults may benefit from resective surgery, but the age range of his patients did not include the very young1. Traditionally, focal seizures have been more difficult to diagnose in the young child, both clinically and electrographically, and a focal onset to seizures may not be readily apparent. However, the advent of magnetic resonance imaging (MRI), with the increased detection of structural focal brain abnormality, has opened up the possibility of surgery at an earlier stage in the natural history of childhood epilepsy.