Carmen Barba, MD, PhD, Meyer Children’s Hospital, University of Florence, Florence, Italy, discusses hot topics in the field of pediatric epilepsy surgery. Surgical interventions are valuable therapeutic options in a number of childhood epilepsies but are often overlooked due to safety concerns. There is often a desire to test numerous pharmacologic strategies prior to considering surgery as an option. However, new studies have been showing that in several epilepsies, such as focal cortical dysplasia, achieving a response with antiseizure medication after the first line agent has failed is unlikely. A new definition of drug resistance in pediatric patients is therefore being considered, different from that in adults. Another key area of development is the use of genetics for epilepsy surgery outcome prediction. Numerous studies have shown that genetic data can provide insights on the potential value of epilepsy surgery. Prof. Barba recommends that genetic testing should be performed prior to pediatric epilepsy surgery wherever possible. This interview took place at the American Epilepsy Society (AES) Annual Meeting 2022 in Nashville, TN.
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