Epileptic spasm (ES) is one of the most common types of seizures in children. It is primarily characterized by brief axial contractions lasting less than 2 s and recurring in short clusters. It usually occurs in children of 3 to 12 months of age, although it can also occur after the age of 1 year. In general, children with ES develop other symptoms of epilepsy, such as tonic, tonic-clonic, or focal seizures, after 3 to 5 years of age. ES in children is often damaging and usually results in developmental regression. First-line treatments for spasm seizures include adrenocorticotropic hormone (ACTH) and vigabatrin. However, many patients fail to respond to these medications, and continued to have spasms associated with progressive neurodevelopmental degeneration. Therefore, it is important to consider whether children with drug resistance meet surgical indications to consider surgical treatment in such conditions. In this study, we reviewed and summarized the importance of preoperative evaluation in order to provide surgical options for treatment of children with ES.

Stereoelectroencephalography (SEEG) has been widely used in the presurgical evaluation of patients with medically intractable epilepsy. In the past, SEEG was commonly used as a method for mapping and localizing the epileptogenic zone (EZ). Since 2004, several studies have been conducted to examine the effectiveness of SEEG-guided radiofrequency thermocoagulation (RF-TC) in treating refractory epilepsy. However, the seizure-free and responder rates varied greatly across studies. We aimed to analyze the outcome of 56 patients who were treated with SEEG-guided RF-TC to evaluate the effectiveness of this treatment. SEEG-guided RF-TC can be considered as a treatment for refractory epilepsy. However, due to its limited efficacy, SEEG-guided RF-TC might be regarded as a temporary treatment performed under SEEG rather than a promising treatment for refractory epilepsy.

Encephalitis is an acute inflammatory process of the brain parenchyma, which is often caused by viral infection. It is an vital cause of acute symptomatic seizures and subsequent epilepsy. The incidence of unprovoked and recurrent seizures after previous infections of the central nervous system is high and accounts for 1%~5% of the cases of epilepsy. Viral encephalitis (VE) is directly caused by viral infection. The occurrence of seizures after VE is associated with poor prognosis. In survivors of VE, among other neurological sequelae, the risk of developing epilepsy is increased 10-fold. The risk of severe neurological sequelae after VE is particularly high in very young children. Studies on seizure occurrence, possible underlying mechanisms, clinical characteristics, and clinical treatment (especially surgical treatment) of VE have yielded only limited detailed data. We reviewed the most recent literature on the clinical features and surgical treatment of post-VE epilepsy.

For some patients with drug-resistant focal epilepsy, we usually select conventional surgical resection, which has brought better outcomes. However, others are not eligible for a conventional open surgical resection of the epileptogenic zone because of the proximity of a functional area or the implication of a larger epileptogenic network. Initially, stereoelectroencephalography (SEEG) exploration was a method of electroencephalography recording that was used in the presurgical evaluation of epileptic patients with complex epilepsy. Later, intracerebral electrodes used for SEEG were applied to produce radio frequency thermocoagulation (RF-TC) in epileptic patients. SEEG-guided RF-TC has produced some promising results, especially in the last dacade. Now, it has become popular as a palliative treatment to reduce seizure frequency in patients with drug-resistant focal epilepsy. This article presents a review of SEEG-guided RF-TC.