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Current concepts in pediatric epilepsy surgery: Time is brain!


Published in: Cesk Slov Neurol N 2026; 89(4): 219-233
Category: Minimonography
doi: https://doi.org/10.48095/cccsnn2026219

Overview

Epilepsy surgery represents a highly effective yet still underutilized treatment option for drug-resistant epilepsy in children. This minimonography outlines the current concept of pediatric resective epilepsy surgery with particular emphasis on early indication and comprehensive outcome assessment. It discusses candidate selection criteria, types of surgical procedures and their personalization, recent findings on surgical complications, and the importance of advanced presurgical diagnostics, including genetic testing and computer-based expert tools for neuroimaging and EEG evaluation. Developments in intraoperative monitoring and its impact on surgical safety are also addressed. Surgical outcomes should be assessed not only by postoperative seizure control, but also in terms of medication withdrawal, cognitive and behavioral development, and quality of life. The concept of “time is brain” is emphasized –⁠ early surgical intervention increases the likelihood of complete recovery and may even prevent the development to pharmacoresistance.


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