Surgery on infants and children to treat epilepsy is gaining in popularity

September 29, 1992|By New York Times News Service

LOS ANGELES -- Epilepsy surgery is gaining in popularity as techniques for finding diseased tissue and removing it have improved, said Dr. William Theodore, chief of the clinical epilepsy branch at the National Institute of Neurological Diseases and Stroke in Bethesda, Md. But the most spectacular results are being seen in babies and very young children.

"We've always hoped that kids with uncontrollable seizures would outgrow it," Dr. Theodore said. "But a significant number do not. Now there is increasing evidence that the earlier you operate, the better you help them avoid later neurological and social problems."

Dr. Harry Chugani, a brain imaging specialist at UCLA, says he thinks he knows why.

Using a technique that injects radioactive tracers into babies' brains before and after surgery, Dr. Chugani maintains that he has the first real proof that human brains can make extensive reconnections after surgery, but only if the patient is 5 years of age or younger, preferably 2 or under.

But some experts criticize the methods used at UCLA. "They do a spectacular job with surgery and helping families," said Dr. John Freeman, director of the pediatric epilepsy center at Johns Hopkins Medical School in Baltimore. But the radioactive imaging technique -- positron emission tomography, or PET -- is not the only way to make a diagnosis, he said. Children can be assessed for surgery without exposing the rapidly dividing brain cells to radioactive substances, he said.

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