Brain surgery may be a good option for even the tiniest baby suffering from epilepsy, new Canadian research reveals. Not only can surgery stop or greatly reduce the seizures, it may also benefit babies' brain development.
The study, from researchers at British Columbia's Children's Hospital, reviewed epilepsy surgeries in children under three years of age in hospitals across Canada that perform pediatric brain surgery. Between 1987 and 2005, there were 116 such surgeries in eight hospitals.
At the time of surgery, children were having an average of 21 seizures per day, with one child having as many as 600 a day. Most of the kids -- 82 per cent -- started to suffer seizures in their first year of life.
The children generally underwent major brain operations that included removal of or disconnection of large sections of the brain. Despite such large operations, there were few complications, though there was one death.
Of the others, 67.3 per cent were seizure-free one year after surgery, while 14 per cent had a greater than 90 per cent improvement in seizures. Only 7.5 per cent did not benefit from surgery, the authors report in the journal Epilepsia.
Brain development improved in 55.3 per cent of the children after surgery.
Neurosurgeon Dr. Paul Steinbok of the University of British Columbia, who led the study, says the report's findings show that surgery can benefit epileptics of any age.
"The results of this study lead us to conclude that epilepsy surgery in children under three years is relatively safe and is effective in controlling seizures," he said.
"Thus, very young age is not a contraindication to surgery in children with epilepsy that is difficult to control with medications."
Ten-year-old Kira Bennett is one of the children who has benefited from the surgery. By the time Kira was four months old, she was having epileptic seizures too numerous to count.
"There would be days when there were over 100 seizures a day," remembered her mother, Lynda Bennett. "I would stop counting at 100 because I was breaking down, at that point."
While medications control epilepsy in most kids, they just don't work for about a third of them. So Bennett decided to agree to the surgery that would remove the part of Kira's brain that seemed to trigger the seizures.
She had the surgery at 15 months of age. The seizures completely disappeared almost immediately.
"When we walked into recovery, she opened her eyes and we looked in her eyes. She was a 15-month-old baby but we could see there was something different, something good was happening," Bennett remembered.
"There were no more seizures or no more seizures that were going to affect her," Bennett said. "So we just thank God for all our life holds for us now. Today, life is awesome."
Dr. Mary Connolly, a neurologist at B.C. Children's Hospital who was also involved in the study, said it's unfortunate that the parents of kids who don't respond to anti-seizure medications don't consider surgery earlier.
"We have sometimes had parents who think surgery is too daunting and they decide to continue with medical therapy," she said. "As we get more and more experience of surgery in infancy, then parents will realize it's an effective treatment and not a treatment of last resort."
Steinbok added that the surgery can actually help children's development, noting that epilepsy can interfere with a child's ability to learn.
"Many of these people were having hundreds of seizures a day. They can't function... and the seizures are stopping the brain from learning," he said. "So we would encourage people around the world to use this surgery earlier in life and expect to get those good results."
Schoolgirl Kira still has some disabilities, scars from her early life with epilepsy, and she still undergoes rehabilitation therapy. But the seizures that marred her infancy are gone.
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip
