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The pediatric neurosurgeon and neurologist will meet with you to discuss your child’s individualized surgical plan with test results and risks and benefits specifically reviewed. They will also talk about your child’s hospitalization and what to expect after the surgery. Your child will need a physical exam by your pediatrician as well as pre-operative blood tests. Evaluations by other specialists and anesthesiologists necessary before surgery can be scheduled. The neurologist may decrease or change some of your child’s seizure medications one to two weeks before surgery. The Neurosurgery Department will call you to schedule the date and time of your child’s surgery and give you detailed instructions. The epilepsy surgery team will help adjust seizure medications prior to surgery as needed.
After surgical placement of the electrode grids, your child will be taken to the intensive care unit (ICU) to be monitored closely for approximately 24 hours. Your child will spend at least one night in the ICU after surgery. Your child’s head will be wrapped in a sterile bandage for the entire time the electrodes are in place. Following the stay in the ICU, your child will return to A-7 Epilepsy Monitoring Unit (EMU). You may stay with your child in the ICU and on the EMU. We may decrease or stop your child’s seizure medications to allow him to have seizures. The wires from the electrodes implanted in your child’s brain will be attached to a VEEG machine on the EMU to allow the epilepsy surgery team to continuously monitor your child’s seizure activity with the intracranial grids in place. We also have continuous video surveillance of seizures as they occur and periodic neurological exams. Your child will receive intravenous antibiotics, steroids and medications while being monitored. She will also have a CT scan of the brain after surgery.
After the second (resective) surgery, your child will spend at least one night in the intensive care unit and then will be transferred to the A-7 Neuroscience Unit for recovery prior to discharge. The sterile head bandage will be removed the second day after surgery. We will order medication for discomfort, and your child will be able to get out of bed. We will obtain a CT scan during this time. Typically, your child will be ready to go home within three to five days after the second surgery. Before your child goes home, your doctor or nurse practitioner will discuss care of the surgical incision, when your child can return to school and activity restrictions. We will also review these items with you at your follow-up appointments.
We will schedule a postoperative visit with our staff in the Epilepsy Surgery Clinic within seven to 10 days. Your child will not be able to return to school until he has had a full recovery, usually in two to six weeks. Appointments will be scheduled for six months, one year, two years, and so on, after surgery. Neuropsychological testing will be done yearly to help evaluate results of surgery and needs of your child. Your child will resume care with her primary neurologist after surgery.
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