Evidence map›Paper›PMID 42227967›Full record

ArticleEpilepsia2026

Pediatric epilepsy surgery: Global survey of referral and presurgical evaluation practices.

Georgia Ramantani, J Helen Cross, Dorottya Cserpan, Emtnan Ahemad, Javier Aparicio, Alexis Arzimanoglou, Carmen Barba, William Bingaman, Kees Braun, Richard J Burman and 37 more

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In one paragraph

Article in Epilepsia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

47 authors.

Georgia RamantaniDepartment of Neuropediatrics, University Children's Hospital, University of Zurich, Zurich, Switzerland.ORCID https://orcid.org/0000-0002-7931-2327
J Helen CrossGreat Ormond Street Hospital for Children, London, UK.ORCID https://orcid.org/0000-0001-7345-4829
Dorottya CserpanDepartment of Neuropediatrics, University Children's Hospital, University of Zurich, Zurich, Switzerland.ORCID https://orcid.org/0000-0002-7538-1931
Emtnan AhemadEpilepsy Department, Great Ormond Street Hospital for Children, London and Royal Aberdeen Children's Hospital, Aberdeen, UK.ORCID https://orcid.org/0009-0000-3058-8915
Javier AparicioEpilepsy Unit, Hospital Sant Joan de Déu, member of European Reference Network EpiCARE, Barcelona, Spain.ORCID https://orcid.org/0000-0002-2143-0953
Alexis ArzimanoglouEpilepsy Unit, Hospital Sant Joan de Déu, member of European Reference Network EpiCARE, Barcelona, Spain.ORCID https://orcid.org/0000-0002-7233-2771
Carmen BarbaMeyer Children's Hospital Istituto di Ricovero e Cura a Carattere Scientifico and University of Florence, Florence, Italy.ORCID https://orcid.org/0000-0001-5445-5842
William BingamanEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0001-8395-1167
Kees BraunDepartment of Child Neurology, Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands.ORCID https://orcid.org/0000-0003-3631-0003
Richard J BurmanDivision of Neurosurgery, Department of Surgery, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0003-3107-7871
James ButlerMediclinic Constantiaberg Hospital, Division of Neurology, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0003-1978-6894
Lixin CaiPediatric Epilepsy Center, Peking University First Hospital, Peking, China.ORCID https://orcid.org/0000-0001-8231-6428
Dezhi CaoEpilepsy Center, Shenzhen Children's Hospital, Shenzhen, China.ORCID https://orcid.org/0000-0002-7424-8063
Roberto CaraballoDepartment of Neurology, Hospital de Pediatría "Prof. Dr. Juan P Garrahan", Buenos Aires, Argentina.ORCID https://orcid.org/0000-0003-0259-1046
Mathilde Chipaux-RaffoPediatric Neurosurgery Department, Rothschild Foundation Hospital, Centre de Compétence Maladies Rares, Epilepsies Rares, Member of European Reference Network EpiCARE, Paris, France.ORCID https://orcid.org/0000-0002-8454-7374
Thomas CloppenborgDepartment of Epileptology, Bethel Epilepsy Center, Medical School Ostwestfalen-Lippe, Bielefeld University, Bielefeld, Germany.ORCID https://orcid.org/0000-0002-6688-6575
Arthur CukiertClinica Cukiert, Sao Paolo, Brazil.ORCID https://orcid.org/0000-0002-6563-4149
Cristine Mella CukiertClinica Cukiert, Sao Paolo, Brazil.
Sameer DalQueensland Children's Hospital, Brisbane, Queensland, Australia.ORCID https://orcid.org/0000-0002-9899-0537
Dario EnglotDepartment of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0001-8373-690X
Noelle EnrightGreat Ormond Street Hospital for Children NHS Trust, Developmental Neurosciences, University College London-Great Ormond Street Institute of Child Health, London, UK.ORCID https://orcid.org/0000-0001-5332-5149
Aria FallahDepartment of Neurosurgery, David Geffen School of Medicine at University of California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-9703-0964
Sarah Ferrand SorbetsPediatric Neurosurgery Department, Rothschild Foundation Hospital, Centre de Compétence Maladies Rares, Epilepsies Rares, Member of European Reference Network EpiCARE, Paris, France.ORCID https://orcid.org/0000-0002-0830-3730
Martha FeuchtDepartment of Pediatrics, Medical University of Vienna, member of European Reference Network EpiCARE, Vienna, Austria.ORCID https://orcid.org/0000-0001-7691-8158
Deepak GillChildren's Hospital at Westmead, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-6219-9479
Laura Guio MahechaFundación Hospital Pediátrico la Misericordia, Bogotá, Colombia.
Aris HadjinicolaouDivision of Neurology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte Justine and Université de Montréal, Montreal, Quebec, Canada.ORCID https://orcid.org/0000-0002-9926-2080
Tove HallböökQueen Silvia Children's Hospital, Sahlgrenska University, Gothenburg, Sweden.
A Simon HarveyRoyal Children's Hospital, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-6388-7444
Hans HolthausenCenter for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, Germany.ORCID https://orcid.org/0000-0001-9221-0109
Yuwu JiangPediatric Epilepsy Center, Peking University First Hospital, Peking, China.ORCID https://orcid.org/0000-0002-5179-9807
Lakshminarayanan KannanGleneagles Hospital, Chennai, Tamilnadu, India.ORCID https://orcid.org/0000-0003-1515-5278
Kalman A KatlowitzDivision of Pediatric Neurosurgery, Department of Surgery, Texas Children's Hospital, Houston, Texas, USA.ORCID https://orcid.org/0000-0001-5568-6343
Katarzyna Kotulska-JóźwiakDepartment of Neurology and Epileptology, Children's Memorial Health Institute, Warsaw, Poland.ORCID https://orcid.org/0000-0002-5015-250X
Martin KudrDepartment of Pediatric Neurology, Charles University and Motol and Homolka University Hospital, full member of European Reference Network EpiCARE, Prague, Czech Republic.ORCID https://orcid.org/0000-0001-7853-3446
Matt LallasDepartment of Neurology, Nicklaus Children's Hospital, Miami, Florida, USA.ORCID https://orcid.org/0009-0003-8034-9885
Ahsan Moosa Naduvil ValappilEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0002-3123-5713
Sandeep Bhagwan PatilDeenanath Mangeshkar Hospital and Research Center, Pune, India.ORCID https://orcid.org/0000-0002-1697-3267
Tom PieperCenter for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, Germany.
Nicola SpecchioNeurology, Epilepsy, and Movement Disorders Unit, Bambino Gesù Children's Hospital, IRCCS, full member of European Reference Network EpiCARE, Rome, Italy.ORCID https://orcid.org/0000-0002-8120-0287
Manjari TripathiDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, India.ORCID https://orcid.org/0000-0003-2201-5644
Lejla VendeghBethesda Children's Hospital, Budapest, Hungary.
Howard WeinerDivision of Pediatric Neurosurgery, Department of Surgery, Texas Children's Hospital, Houston, Texas, USA.
Jo WilmshurstDivision of Paediatric Neurology, Department of Paediatrics and Child Health, Neuroscience Institute, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-7328-1796
Mary Lou SmithHospital for Sick Children, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-1937-1026
Elaine WirrellMayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0003-3015-8282
ILAE Pediatric Epilepsy Surgery Task Force and Study Group

Funding

Anna Mueller Grocholski FoundationSchweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung 208184
6 · The paper itself

Abstract

objectivePediatric epilepsy surgery is well established, but contemporary global data on referral and presurgical evaluation practices are lacking. This International League Against Epilepsy (ILAE) Pediatric Epilepsy Surgery Task Force study provides an updated overview of current trends and regional differences.

methodsGroup-level data were collected from 61 epilepsy surgery programs (49 pediatric-only) across 29 countries and six continents, identified through ILAE networks, and included all children and adolescents treated in 2023 who underwent presurgical evaluation/epilepsy surgery.

resultsGroup-level data were available for 2427 patients. Mean age at surgery was 9.1 ± 4.9 years; mean epilepsy duration was 5.3. At surgery, 3.2% were <1 year old (highest in Oceania: 5.1%), and 6.1% were nonpharmacoresistant (highest in Europe: 15.0%). Prior neurosurgery was reported in 14.2% (highest in North America: 28.8%), including 8.0% resections (6.1% for epilepsy, 1.5% for tumors; highest in Oceania: 16.5%), 2.3% disconnections (1.3% corpus callosotomy; highest in South America: 4.7%), and 4.2% neuromodulation (3.7% vagal nerve stimulation, .2% responsive neurostimulation, one deep brain stimulation; highest in North America: 12.2%). Developmental and epileptic encephalopathies (DEEs) at surgery included Lennox-Gastaut syndrome (7.4%), infantile epileptic spasms syndrome (5.1%), and DEE with spike-wave activation in sleep (1.5%). Presurgical investigations included fluorodeoxyglucose positron emission tomography (52.6%; highest in Oceania: 79.7%), genetic testing (46.8%; highest in Asia: 54.3%), magnetic resonance imaging (MRI) postprocessing (32.4%; highest in South America: 53.0%), functional MRI (fMRI; 15.2%; highest in North America: 40.3%), magnetoencephalography (11.9%; highest in North America: 39.3%), single photon emission computed tomography (9.6%; highest in North America: 22.2%), high-density electroencephalography (EEG; 1.9%; highest in Europe: 4.7%), source localization (1.6%; highest in Oceania: 7.6%), Wada test (1.2%; highest in North America: 3.5%), and EEG-fMRI (.5%; highest in Europe: 1.1%). SIGNIFICANCE: Despite some early surgeries, including in infancy and before pharmacoresistance, mean epilepsy duration before surgery remains >5 years. Reoperations are common, with resection more frequent than neuromodulation. Genetic testing in nearly half of patients reflects its growing relevance, and the high rate of DEEs underscores the complexity of surgical candidates.

Indexed as

EpilepsyNeurosurgical ProceduresPreoperative CareReferral and ConsultationAdolescentChildChild, PreschoolFemaleHumansInfantMaledevelopmental and epileptic encephalopathies (DEEs)genetic testingneuromodulationpediatric epilepsy surgerypresurgical evaluationreoperations

Identifiers

PMID42227967
PMCPMC13525590

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