(663) Immediate Postoperative Course in the PICU Following Pediatric Epilepsy Surgery

Introduction: In the last few decades, epilepsy surgery gained popularity and has shown significant advantages over medical treatment in children and adults with drug resistant epilepsy. The purpose of this study is to describe the immediate postoperative PICU course and short-term outcomes of children undergoing various epilepsy surgeries (ES).

Methods: Single-center, retrospective observational study. All patients younger than 20 years of age who had been admitted to the PICU between 2018-2022 following ES were eligible for study entry.

Results: Fifty-two children (median age 7.9 years) underwent ES during the study period (25 focal lesionectomies and lobectomies[FL], 10 corpus callosotomy [CC], and 17 hemispheric surgery [HS]). The average number of preoperative antiseizure medications (ASM) was 3, and the average number of failed ASM was 6. Cortical dysplasia was the most frequent etiology (25%). Preoperative cognitive delay and motor deficits were reported in 38 (74%) and 26 (50%) patients, respectively. The median length of stay in the PICU was 1 day (5 for the HS group). No seizures occurred among 44 (85%) children during the first postoperative day nor during the entire hospital stay in 40 (77%) patients (20/25 [82%] in the FL group, 4/10 [40%] in the CC group, and 14/17 [82%] in the HS group). There were no status epilepticus events during the PICU stay. None of patients required hemodynamic support, and only 3(6%) needed respiratory support. Twenty-six patients (50%) had electrolyte abnormalities. Pain was mostly perceived as mild. Fever was present in 28 (54%) patients, most notably in the HS group (94%).

Conclusions:

Conclusions: ES in children was associated with very limited immediate postoperative morbidity and low seizure burden, especially in the FL and HS groups.