Pediatric Epilepsy Surgery Program

Overview

After headache, epilepsy is the most common neurologic problem in children. Mass General for Children offers a full range of medical management and all of the established and new anti-epileptic drugs. Most pediatric seizure disorders are well managed with appropriate medical therapy. Where medical management fails, however, or when a condition is found for which surgery is the best option, a child should be evaluated carefully for surgical intervention.

We offer all forms of surgical epilepsy treatment, including:

• Cortical resections
• Temporal lobectomies
• Hemispherectomies and hemispheric disconnection procedures
• Callosotomies
• Multiple subpial transections
• Vagus nerve stimulation
• Placement of subdural grids and depth electrodes

At Mass General for Children, the recommendation to consider surgery is initially made by the epilepsy surgery team, a comprehensive multi-disciplinary group comprising:

• Pediatric epileptologists
• Neurologists
• Neurosurgeons
• Neuropsychologists
• Psychologists
• Nurses
• Neuro-clinical social workers
• EEG technologists
• Occupational therapists

Comprehensive Evaluation

The evaluation usually includes a hospital stay for EEG monitoring, with 24-hour continuous video monitoring. To aid in the surgical evaluation, some of the most advanced imaging capabilities in the world are being utilized. In addition to standard CT and MRI, offerings include PET (positron emission tomography) scanning for looking at the body’s biochemical functions, functional MRI for providing 3D structural and functional brain imaging, MR spectroscopy for viewing the neurochemistry of the brain and special, high-resolution MRI scanning provide detailed anatomical views, and magnetoencephalography.

The evaluation is conducted on the pediatric unit with special pediatric support systems in place, including dedicated epilepsy nurse specialists and pediatric neurosurgery nurse practitioners who provide ongoing support for the child and family throughout the child’s treatment plan.