Pediatric Epilepsy Surgery

World-Class Expertise in the diagnosis and surgical management of pediatric epilepsy

Over the past 4 decades, we have pioneered novel treatments, protocols, diagnostic tools and evidenced-based guidelines that are being used by many children’s hospitals throughout the world. We continue to push the boundaries of possibilities through expert care and compassion while inventing the future of epilepsy surgery. Watch Video: A Modern and Comprehensive Approach to Pediatric Epilepsy Surgery.

We have decades of experience with over 2000 epilepsy operations performed since the program’s inception, including over 100 new surgical cases per year, making our program one of the highest volume centers in the world. We have a “No child will be left behind” mentality when it comes to our patients. The underlying theme to our program revolves around two critical questions: 1) Can the part of the brain that causes the epilepsy be identified and safely treated? 2) Does the control of the epilepsy restore a more normal life experience?

Epilepsy in children can be severely debilitating, but early diagnosis and treatment can be instrumental in helping a child reach full cognitive potential. The majority of children who are able to have surgery become seizure free. Some require anticonvulsants but others remain seizure free, even after the medications have been stopped. Some of the most common conditions that we treat with epilepsy surgery include cortical dysplasia, perinatal cerebral infarcts, temporal lobe lesions, gliosis, hemimegalencephaly, Rasmussen syndrome, Sturge-Weber syndrome, Tuberous Sclerosis Complex, Hypothalamic Hamartomas and Epilepsy caused by brain tumors, cavernous malformations of arteriovenous malformations.

We are truly a comprehensive surgical epilepsy program as we offer the entire spectrum of diagnostic surgeries including stereotactic electroencephalography and subdural grid implantation, resective epilepsy surgeries ranging from very focused resections to large hemispheric resections as well as MR- guided laser thermal therapy for minimally invasive treatments. For children that are deemed not a candidate for resective surgery, we have access to implanting the latest generation of vagal nerve stimulators and responsive neurostimulation. Very few centers have access to the latest technologies and have expertise with the whole spectrum of surgical procedures to treat pediatric epilepsy.

We have weekly multidisciplinary meetings including pediatric neurosurgeons, pediatric neurologists, pediatric neuroradiologists, child psychiatrists, pediatric neuropsychologists, neuropathologists and nursing where we discuss the unique features of each child’s epilepsy to determine the optimal management plan.

Our faculty each have a focused area of clinical and research interest and are recognized leaders in their fields. We have ongoing research projects in identifying the biomarkers of epilepsy, developing novel treatments through ongoing clinical trials and predicting surgical outcomes through multi-center global collaborations. Our mission is simple: To improve the lives of children affected by epilepsy while focused on inventing the therapies of the future.

Recent Publications

• Early autism symptoms in infants with tuberous sclerosis complex.
  McDonald NM, Varcin KJ, Bhatt R, Wu JY, Sahin M, Nelson CA 3rd, Jeste SS.
  Autism Res. 2017 Aug 11. doi: 10.1002/aur.1846.
• Pretreatment seizure semiology in childhood absence epilepsy.
  Kessler SK, Shinnar S, Cnaan A, Dlugos D, Conry J, Hirtz DG, Hu F, Liu C, Mizrahi EM, Moshé SL, Clark P, Glauser TA; Childhood Absence Epilepsy Study Group.
  Neurology. 2017 Jul 19. pii: 10.1212/WNL.0000000000004226. doi: 10.1212/WNL.0000000000004226.
• High-frequency oscillations: The state of clinical research.
  Frauscher B, Bartolomei F, Kobayashi K, Cimbalnik J, van 't Klooster MA, Rampp S, Otsubo H, Höller Y, Wu JY, Asano E, Engel J Jr, Kahane P, Jacobs J, Gotman J.
  Epilepsia. 2017 Aug;58(8):1316-1329. doi: 10.1111/epi.13829. Epub 2017 Jun 30. Review.
• Intraoperative fast ripples independently predict postsurgical epilepsy outcome: Comparison with other electrocorticographic phenomena.
  Hussain SA, Mathern GW, Hung P, Weng J, Sankar R, Wu JY.
  Epilepsy Res. 2017 Jun 16;135:79-86. doi: 10.1016/j.eplepsyres.2017.06.010. 
• Risk of vigabatrin-associated brain abnormalities on MRI in the treatment of infantile spasms is dose-dependent.
  Hussain SA, Tsao J, Li M, Schwarz MD, Zhou R, Wu JY, Salamon N, Sankar R.
  Epilepsia. 2017 Apr;58(4):674-682. doi: 10.1111/epi.13712. Epub 2017 Feb 23.
• Prospective and "live" fast ripple detection and localization in the operating room: Impact on epilepsy surgery outcomes in children.
  Hussain SA, Mathern GW, Sankar R, Wu JY.
  Epilepsy Res. 2016 Nov;127:344-351. doi: 10.1016/j.eplepsyres.2016.09.017. Epub 2016 Sep 23.
• Long-Term Use of Everolimus in Patients with Tuberous Sclerosis Complex: Final Results from the EXIST-1 Study.
  Franz DN, Belousova E, Sparagana S, Bebin EM, Frost MD, Kuperman R, Witt O, Kohrman MH, Flamini JR, Wu JY, Curatolo P, de Vries PJ, Berkowitz N, Niolat J, Józwiak S.
  PLoS One. 2016 Jun 28;11(6):e0158476. doi: 10.1371/journal.pone.0158476. eCollection 2016.
• Aria Fallah et al. Cost-utility analysis of competing treatment strategies for drug-resistant epilepsy in children with Tuberous Sclerosis Complex. Epilepsy & Behavior. Vol. 63. Oct 2016.
• Aria Fallah. Moving beyond evidence-based medicine: Incorporating patient values and preferences. Epilepsy & Behavior. Vol. 53. Dec 2015.
• Aria Fallah et al. Resective Epilepsy Surgery for Tuberous Sclerosis in Children: Determining Predictors of Seizure Outcomes in a Multicenter Retrospective Cohort Study. Neurosurgery. Vol. 77. Oct 2015.
• Wang S., Fallah A. Optimal management of seizures associated with tuberous sclerosis complex: current and emerging options. Neuropsychiatric Disease and Treatment. Vol. 10. Oct 2014.
• Aria Fallah et al. Predictors of Seizure Outcomes in Children with Tuberous Sclerosis Complex and Intractable Epilepsy Undergoing Resective Epilepsy Surgery: An Individual Participant Data Meta-Analysis. PLoS ONE. 8(2): e53565.

Webinars

Hemispherectomy: When Half the Brain is Better than the Whole – Aria Fallah, MD
Modern and Comprehensive Management of Pediatric Epilepsy Surgery – Aria Fallah, MD

Children who continue to have seizures despite medical therapy may be candidates for curative epilepsy surgery
Curative Epilepsy Surgery (PDF)