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Approximately 60% of all patients with epilepsy suffer from focal epilepsy syndromes. In about 15% of these patients the
seizures are not adequately controlled with anticonvulsive drugs and such patients are potential candidates for surgical
treatment and major proportion is in the paediatric group (18 years old or less). Epilepsy surgery in children who have been
carefully chosen can result in either seizure freedom or a marked (>90%) reduction in seizures in approximately two thirds of
children with intractable seizures. Advances in structural and functional neuroimaging, neurosurgery, and neuroanaesthesia
have improved the outcomes of surgery for children with intractable epilepsy. Early surgery improves the quality of life, cognitive
and developmental outcome and allows the child to lead a normal life and contribute to the society. Surgically remediable
epilepsies should be identified early and include temporal lobe epilepsy with hippocampal sclerosis, lesional temporal, extra
temporal epilepsies, hemispherical epilepsies and gelastic epilepsy with hypothalamic hamartoma. These syndromes have both
acquired and congenital etiologies and can be treated by resective or disconnective surgery. Palliative procedures are performed
in children with diffuse and multifocal epilepsies who are not candidates for resctive surgery. The palliative procedures include
corpus callosotomy, vagal nerve stimulation while deep brain stimulation in epilepsy is still under evaluation. For children with
with �surgically remedial epilepsy� surgery should be offered as a procedure of choice, rather than as a treatment of last resort.
Manas Panigrahi did his M.Ch. from National Institute of Mental Health and Neurosciences, Bangalore, India. Currently working as Consultant Neurosurgeon at Krishna Institute of Medical Sciences and is a Member of Neurological Society of India and International member of Congress of Neurological Surgeons. Manas panigrahi has been awarded Andhra Pradesh Neuroscientist Gold Medal in 2005, APNSI Gold Medal for presenting a paper on ?Surgical Management of Anterior Circulation Aneurysms??, and has got Dr Capt. C. Venkaiah Memorial Oration medal in 2010. He has published many national and international papers on neurology to his credit.
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