Abstract
RATIONALE: Epilepsy surgery in children is no longer considered a last resort for drug-resistant seizures; however, there are no studies that address the impact of pediatric epilepsy surgery on endocrine function. We reviewed patients in the Global Pediatric Epilepsy Surgery Registry to assess the prevalence of various endocrinopathies after epilepsy surgery in childhood. METHODS: Retrospective data was collected for 122 patients, via parent proxy, who had epilepsy surgery before age 18. Data were collected on age, height, weight, seizure etiology, and surgery type, as well as reported endocrine diagnoses. Descriptive statistics were tabulated and group differences assessed. RESULTS: 22.7% of patients were followed by an endocrinologist after surgery, but not before. 9.8% of patients reported one diagnosed endocrine disorder post-operatively, including precocious puberty (5.7%) and diabetes insipidus (0.8%); 3.3% had more than one diagnosed endocrine disorder. A higher incidence of diagnosed endocrinopathies was found in children after hemispherectomy surgery (12.64%) or who acquired hydrocephalus after surgery (30%) than in other forms of surgery. 16.4% of parents report that the child had “excessive weight gain” after surgery and 9.8% report “excessive weight loss” after surgery. CONCLUSION: Endocrine dysfunction, including precocious puberty and disorders of water balance, appears to be common after epilepsy surgery in childhood, especially hemispherectomy. Longitudinal studies are needed to better understand the etiology and true prevalence of these disorders. The Global Pediatric Epilepsy Surgery Registry is the first longitudinal study with this aim.