{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T21:29:32Z","timestamp":1792445372871,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:00:00Z","timestamp":1735257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>At our institute, most pediatric patients undergo epilepsy surgery following a thorough presurgical evaluation without intracranial electroencephalography (EEG). We conducted an initial validation of our noninvasive presurgical strategy by assessing the seizure and developmental outcomes of 135 children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All 135 pediatric patients were &lt;15\u2009years old, had undergone curative surgery, and were followed for at least 2\u2009years postoperatively. Presurgical evaluations and postoperative seizure and developmental outcomes were investigated. Thorough noninvasive evaluation included 3\u2010T magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG\u2010PET) in all patients. Intracranial EEG was mainly indicated for patients whose MRIs were negative or subtle. We defined Engel class I as favorable and Engel classes II\u2013IV as unfavorable seizure outcomes. Intelligence quotient (IQ) and developmental quotient (DQ) before and 2\u2009years after surgery were used to assess developmental\/neuropsychological outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>MRI was positive in 130 of 135 patients (96.3%), including 39 of 40 with focal cortical dysplasia (FCD) type II and 30 of 33 with FCD type I. FDG\u2010PET revealed concordant localizing findings in 119 of 132 patients (90.2%). Ictal single photon emission computed tomography provided concordant localizing information in 85 of 91 patients (93.4%). Intracranial EEG was performed in only 10 of 135 patients (7.4%). Ninety\u2010seven of 135 patients (71.9%) were seizure\u2010free 2\u2009years after surgery. The final seizure\u2010free rate was 99 of 135 (73.3%). Temporal lobe surgery predicted a favorable seizure outcome by multivariate analysis, whereas FCD type I and preoperative IQ\/DQ\u2009&lt;\u200970 predicted an unfavorable outcome. The mean IQ change was +1.3 points, and the mean DQ change was +1.0 points. Mean DQ significantly improved following extratemporal surgery (multivariate regression, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05), and mean DQ significantly decreased in patients with epileptic spasms (multivariate regression, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Thorough noninvasive presurgical evaluation enables detection of subtle MRI lesions and curative epilepsy surgery without intracranial EEG in most patients, including those with FCD type II and type I, and leads to favorable seizure and developmental\/neuropsychological outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.18249","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T14:54:52Z","timestamp":1735311292000},"page":"1084-1096","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Favorable seizure and developmental outcomes without preoperative intracranial electroencephalography in pediatric patients following epilepsy surgery: A single epilepsy center retrospective study"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6171-0187","authenticated-orcid":false,"given":"Taro","family":"Okumura","sequence":"first","affiliation":[{"name":"National Epilepsy Center NHO Shizuoka Institute of Epilepsy and Neurological Disorders  Shizuoka Japan"},{"name":"Department of Neurosurgery Nagoya University School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9736-7460","authenticated-orcid":false,"given":"Naotaka","family":"Usui","sequence":"additional","affiliation":[{"name":"National Epilepsy Center NHO Shizuoka Institute of Epilepsy and Neurological Disorders  Shizuoka 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