Epilepsy surgery in children: Outcomes of patients with drug-resistant epilepsy at a paediatric hospital in Bogotá, Colombia, with 10 years of follow-up.

Introduction: Drug-resistant epilepsy is defined as the lack of response to two appropriately selected antiepileptic drugs that the patient has tolerated properly. Epilepsy is a common neurological disorder in the paediatric population, with an estimated prevalence ranging from 4.3 to 9.3 cases per 1000 children, affecting 1.2% of the global population. Despite pharmacological treatment, between 30% and 40% of patients fail to achieve adequate seizure control, and approximately half of these become candidates for epilepsy surgery.

Objective: To determine the incidence of seizure freedom, considering the Engel classification, in paediatric patients undergoing epilepsy surgery at a level IV paediatric hospital in Bogotá, Colombia.

Methodology: A retrospective observational cohort study was conducted with paediatric patients treated at a level IV paediatric hospital by the epilepsy surgery team between January 1, 2013, and July 31, 2024.

Results: Between 2013 and 2024, a total of 326 patients were evaluated through the epilepsy surgery programme. Of these, 154 underwent surgery. The median postoperative follow-up was 40months. The type of surgery was significantly associated with a higher likelihood of achieving favourable outcomes at 6months (RR=3.54; 95%CI: 1.86-6.77; p<.001) and 12months of follow-up (RR=4; 95%CI: 1.96-8.08; p<.001). The presence of daily seizures and the need for treatment with more than three medications were associated with a lower likelihood of achieving favourable outcomes during the follow-up period.

Conclusions: The loss of years of healthy life since the diagnosis of epilepsy and the type of surgery performed (palliative or curative) were identified as independent factors strongly associated with favourable outcomes in the treatment of drug-resistant epilepsy.