Evidence map›Paper›PMID 42274288›Full record

ArticleEpilepsia2026

Pediatric epilepsy surgery: Global survey of invasive explorations.

Georgia Ramantani, Martha Feucht, Dorottya Cserpan, Javier Aparicio, Alexis Arzimanoglou, Fabrice Bartolomei, William Bingaman, Kees P J Braun, Richard J Burman, Dezhi Cao and 41 more

Abstract read
PubMed Full text at PMC Publisher
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

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

Corrections and comments

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

51 authors.

Georgia RamantaniDepartment of Neuropediatrics, University Children's Hospital, University of Zurich, Zurich, Switzerland.ORCID https://orcid.org/0000-0002-7931-2327
Martha FeuchtDepartment of Pediatrics, Medical University of Vienna, Member of the European Reference Network for Rare and Complex Epilepsies, Vienna, Austria.ORCID https://orcid.org/0000-0001-7691-8158
Dorottya CserpanDepartment of Neuropediatrics, University Children's Hospital, University of Zurich, Zurich, Switzerland.ORCID https://orcid.org/0000-0002-7538-1931
Javier AparicioEpilepsy Unit, Hospital Sant Joan de Déu, Member of the European Reference Network for Rare and Complex Epilepsies, Barcelona, Spain.ORCID https://orcid.org/0000-0002-2143-0953
Alexis ArzimanoglouEpilepsy Unit, Hospital Sant Joan de Déu, Member of the European Reference Network for Rare and Complex Epilepsies, Barcelona, Spain.ORCID https://orcid.org/0000-0002-7233-2771
Fabrice BartolomeiEpileptology and Cerebral Rhythmology, Assistance Publique-Hôpitaux de Marseille, Hôpital de la Timone, and Institut de Neurosciences Des Systèmes, Inserm, Aix Marseille Université, Marseille, France.ORCID https://orcid.org/0000-0002-1678-0297
William BingamanEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0001-8395-1167
Kees P J BraunDepartment of Child Neurology, University Medical Center 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
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 the European Reference Network for Rare and Complex Epilepsies, 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
J Helen CrossGreat Ormond Street Hospital for Children National Health Service Trust, Developmental Neurosciences, University College London Great Ormond Street Institute of Child Health, London, UK.ORCID https://orcid.org/0000-0001-7345-4829
Arthur CukiertClinica Cukiert, São Paulo, Brazil.ORCID https://orcid.org/0000-0002-6563-4149
Cristine Mella CukiertClinica Cukiert, São Paulo, Brazil.
Daniel J CurryDivision of Pediatric Neurosurgery, Department of Surgery, Texas Children's Hospital, Houston, Texas, USA.ORCID https://orcid.org/0000-0003-3661-2976
Luca De PalmaNeurology, Epilepsy, and Movement Disorders Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Member of the European Reference Network for Rare and Complex Epilepsies, Rome, Italy.ORCID https://orcid.org/0000-0002-0714-8230
Petia DimovaFunctional and Epilepsy Surgery Center, University Hospital St. Ivan Rilski, Sofia, Bulgaria.ORCID https://orcid.org/0000-0002-4443-5140
Christin EltzeGreat Ormond Street Hospital for Children National Health Service Trust, Developmental Neurosciences, University College London Great Ormond Street Institute of Child Health, London, UK.ORCID https://orcid.org/0000-0003-4411-2939
Dario J EnglotDepartment of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0001-8373-690X
Johannes M Nico EnslinDivision of Neurosurgery, Department of Surgery, Neuroscience Institute, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-6384-7781
Aria FallahDepartment of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-9703-0964
Stefano FrancioneChild Neuropsychiatry Unit, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Giannina Gaslini, Genoa, Italy.ORCID https://orcid.org/0000-0002-0577-5193
Deepak GillChildren's Hospital at Westmead, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-6219-9479
Tove HallböökQueen Silvia Children's Hospital, Sahlgrenska University Hospital, 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, Schön Clinic Vogtareuth, Germany.ORCID https://orcid.org/0000-0001-9221-0109
Sita JayalakshmiDepartment of Neurology, Krishna Institute of Medical Sciences, Secunderabad, India.ORCID https://orcid.org/0000-0001-8630-0896
Yuwu JiangPediatric Epilepsy Center, Peking University First Hospital, Beijing, China.ORCID https://orcid.org/0000-0002-5179-9807
Lakshminarayanan KannanGleneagles Hospital, Chennai, India.ORCID https://orcid.org/0000-0003-1515-5278
Matt LallasDepartment of Neurology, Nicklaus Children's Hospital, Miami, Florida, USA.ORCID https://orcid.org/0009-0003-8034-9885
Sandeep Bhagwan PatilDeenanath Mangeshkar Hospital and Research Center, Pune, India.ORCID https://orcid.org/0000-0002-1697-3267
María Ángeles Pérez-JiménezDepartment of Clinical Neurophysiology, Niño Jesús University Children's Hospital, Madrid, Spain.
Juan Carlos Pérez-PovedaHospital Universitario San Ignacio and Pontificia Universidad Javeriana, Bogotá, Colombia.ORCID https://orcid.org/0000-0001-5360-5650
Tom PieperCenter for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schön Clinic Vogtareuth, Germany.
Sabine RonaSwiss Epilepsy Center, Zurich, Switzerland.
Victoria San Antonio-ArceFreiburg Epilepsy Center, Medical Center-University of Freiburg, Member of the European Reference Network for Rare and Complex Epilepsies, and Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0002-2780-6560
Jay ShettyRoyal Hospital for Children and Young People, Edinburgh, UK.ORCID https://orcid.org/0000-0002-3114-4002
Mary Lou SmithHospital for Sick Children and University of Toronto Mississauga, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-1937-1026
Piradee SuwanpakdeeDepartment of Pediatrics, Phramongkutklao Hospital, Bangkok, Thailand.ORCID https://orcid.org/0000-0001-9814-3867
Oana Tarta ArseneClinical Hospital of Psychiatry and Pediatric Neurology Unit/Department of Neurosurgery, Marie Skłodowska Curie Emergency Hospital for Children, Bucharest, Romania.ORCID https://orcid.org/0000-0002-9690-456X
Laura TassiClaudio Munari Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy.ORCID https://orcid.org/0000-0002-0632-7296
Martin TisdallGreat Ormond Street Hospital for Children National Health Service Trust, Developmental Neurosciences, University College London Great Ormond Street Institute of Child Health, London, UK.ORCID https://orcid.org/0000-0001-8880-8386
Manjari TripathiDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, India.ORCID https://orcid.org/0000-0003-2201-5644
Ahsan Moosa Naduvil ValappilEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0002-3123-5713
Howard WeinerDivision of Pediatric Neurosurgery, Department of Surgery, Texas Children's Hospital, Houston, Texas, USA.
Elaine WirrellDivision of Child and Adolescent Neurology and Epilepsy, Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0003-3015-8282
Lixin CaiPeking University First Hospital, Beijing, China.ORCID https://orcid.org/0000-0001-8231-6428
Sarah Ferrand-SorbetsRothschild Foundation, Paris, France.ORCID https://orcid.org/0000-0002-0830-3730
ILAE Pediatric Epilepsy Surgery Taskforce and Study Group

Funding

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

Abstract

objectiveInvasive presurgical evaluation plays a key role in pediatric epilepsy surgery, particularly in magnetic resonance imaging (MRI)-negative cases, by guiding resective, disconnective, or ablative procedures. This International League Against Epilepsy (ILAE) Pediatric Epilepsy Surgery Taskforce study provides an updated global overview of current invasive evaluation practices.

methodsGroup-level data were collected from 61 epilepsy surgery programs (49 pediatric-only) in 29 countries across six continents. Included were children and adolescents who underwent presurgical evaluation and epilepsy surgery in 2023. The study was designed to enable comparison with the similar ILAE survey conducted in 2004.

resultsA total of 2427 patients were included. Invasive evaluations were performed in 21.1% of cases, most frequently in North America (33.7%, higher than Europe: 18.0%, p = .003). Among invasive cases, 32.3% had no detectable MRI abnormalities. The main indication for invasive evaluation was seizure onset localization (88.1%), followed by motor or sensory mapping (17.2%) and language mapping (14.2%). Stereoelectroencephalography (SEEG) was the predominant technique (19.8% overall, 93.6% of invasive cases), more common in North America (30.0%, p = .021) and less common in South America (7.4%, p < .001). Subdural electrodes were used in only 3.2% of invasive cases, and combined depth and subdural approaches in 3.2%. SEEG-guided radiofrequency thermocoagulation (RF-TC) was performed in 40.9% of SEEG cases, most commonly in Asia (63.8%). In 16.2% of invasive evaluations, patients did not proceed to resection, disconnection, or ablation, with the highest rate in Europe (28.5%). SIGNIFICANCE: This global survey provides the first broad overview of invasive evaluation practices in pediatric epilepsy surgery across participating centers worldwide. It highlights the widespread adoption of SEEG, declining use of subdural electrodes, and increasing application of SEEG-guided RF-TC. The high proportion of MRI-negative cases and the considerable proportion of patients not proceeding to resection, disconnection, or ablation underscore the complexity of contemporary surgical candidates and the need for further refinement of selection strategies.

Indexed as

EpilepsyNeurosurgical ProceduresAdolescentBrain MappingChildChild, PreschoolElectroencephalographyFemaleHumansInfantMagnetic Resonance ImagingMaleglobal surveyinvasive EEGMRI‐negative epilepsypediatric epilepsy surgerySEEG

Identifiers

PMID42274288
PMCPMC13592491

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