{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:56Z","timestamp":1792471136606,"version":"4.5.0"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n Epileptic spasms (ES) in children carry a high risk of neurodevelopmental delay, yet predictors of long\u2010term surgical outcome remain incompletely defined. This study aimed to evaluate seizure outcomes following epilepsy surgery and to identify independent prognostic factors for postoperative recurrence.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study included 73 patients (47 males, 64%; median age at surgery: 37\u2009months, IQR: 20\u201355.5) with drug\u2010resistant ES who underwent resective or ablative surgery at Guangdong Sanjiu Brain Hospital in China between January 2015 and September 2024, with regular follow\u2010up at least 12\u2009months after epilepsy surgery. Independent predictors of recurrence were identified using multivariate Cox proportional hazards regression, and Kaplan\u2013Meier analysis was performed to compare seizure\u2010free survival stratified by seizure duration (SD) and residual lesion status.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Seizure\u2010free rates were 75.3% at 1\u2009year and 55.1% at last follow\u2010up. Mean follow\u2010up was 61.36\u2009\u00b1\u200926.10\u2009months (range: 12\u2013132). Among malformation of cortical development (MCD) subtypes, focal cortical dysplasia (FCD) type II demonstrated the highest 5\u2010year seizure\u2010free rate (100%), whereas mild MCD (m\u2010MCD) showed the lowest (33.3%;\n p<\/jats:italic>\n \u2009=\u20090.039). On multivariate Cox analysis, residual lesion on postoperative MRI was the strongest independent predictor of recurrence (HR\u2009=\u20095.13; 95% CI: 2.28\u201311.51;\n p<\/jats:italic>\n \u2009<\u20090.001), followed by SD exceeding 36\u2009months (HR\u2009=\u20092.49; 95% CI: 1.17\u20135.29;\n p<\/jats:italic>\n \u2009=\u20090.018). Kaplan\u2013Meier analysis confirmed a twofold difference in 5\u2010year seizure\u2010free survival between patients with duration \u226436 versus >36\u2009months (73% vs. 36%; log\u2010rank\n p<\/jats:italic>\n \u2009=\u20090.00069), and significantly better seizure\u2010free survival in patients without residual lesions (log\u2010rank\n p<\/jats:italic>\n \u2009<\u20090.0001).\n <\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n Complete lesion resection and early surgical intervention (SD \u226436\u2009months) are independently associated with favorable long\u2010term seizure outcomes in children with drug\u2010resistant ES. Pathological subtype, particularly FCD type II, further refines prognostic stratification. These findings support prompt surgical referral and underscore the importance of achieving complete lesion removal to optimize postoperative seizure control.<\/jats:p>\n <\/jats:sec>\n \n Plain Language Summary<\/jats:title>\n Some children develop a severe form of epilepsy called epileptic spasms that cannot be controlled with medication. In this study of 73 children who had brain surgery for this condition, more than half remained seizure\u2010free after 5\u2009years. Children who had surgery earlier\u2014before seizures had continued for 3\u2009years\u2014and those in whom the entire abnormal brain tissue was removed did significantly better in the long run. These findings suggest that referring children for surgery sooner rather than later can meaningfully improve their chances of living seizure\u2010free.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/epi4.70305","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T09:59:48Z","timestamp":1783763988000},"page":"1541-1555","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Complete lesion resection and early surgical intervention are favorable factors for long\u2010term seizure freedom in drug\u2010resistant epileptic spasms"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7957-7886","authenticated-orcid":false,"given":"Hua","family":"Li","sequence":"first","affiliation":[{"name":"Department of Epilepsy Center Guangdong Sanjiu Brain Hospital Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8327-4390","authenticated-orcid":false,"given":"Yao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epilepsy Center Guangdong Sanjiu Brain Hospital Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3925-4440","authenticated-orcid":false,"given":"Qiang","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Epilepsy Center Guangdong Sanjiu Brain Hospital Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junxi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epilepsy Center Guangdong Sanjiu Brain Hospital Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaihui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epilepsy Center Guangdong Sanjiu Brain Hospital Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danfang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epilepsy Center Guangdong Sanjiu Brain Hospital Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinghua","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Epilepsy Center Guangdong Sanjiu Brain Hospital Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6062-9527","authenticated-orcid":false,"given":"Jing","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Epilepsy Center Guangdong Sanjiu Brain Hospital Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17239"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000206758"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1518554"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2024.07.009"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2020.01.015"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2020.107578"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13234"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.13007"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s42494\u2010024\u201000176\u20101"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1684\/epd.2021.1237"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3171\/2018.10.PEDS18380"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101167.2009.02397.x"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2017.08.010"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2024.109985"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(06)70626\u20103"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311\u2010014\u20100257\u20102"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.373"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13205"}],"container-title":["Epilepsia 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