When epilepsy is not controlled by medical treatment, surgery should be considered as soon as possible, depending on the type of epilepsy and the possibility of determining its origin.

Physical examination, video EEG tests, imaging and neuropsychological tests may sometimes lead directly to surgery in the simplest cases.

Sometimes it is necessary to go further and conduct what are known as "invasive" tests, with the insertion of intracerebral electrodes to accurately determine the exact source of the epilepsy.

These intracranial investigations may be performed using one of 2 techniques: either the insertion of subdural plates and deep electrodes by craniotomy or stereo-EEG (SEEG) with deep electrodes inserted using the stereotactic robot. In both cases, the child's seizures will be recorded by the intracranial electrodes for a week. Following this intracranial video-EEG monitoring, a decision can be reached concerning which surgery should be performed. This preoperative assessment may sometimes include intracranial brain stimulation (motor or language mapping).

The development of endoscopic methods has made it possible to treat epilepsies due to hypothalamic hamartomas for which there was previously no treatment solution.


Whether a tumour is in a cerebral hemisphere, the posterior fossa or the spinal cord, in addition to emergency procedures if required (treatment of hydrocephalus, intracranial hypertension, spinal cord compression), the long-term treatment is always based on medical and surgical collaboration with specialised oncologists, in partnership with the Institut Curie.


Decompression procedures are performed with or without spinal stabilisation. When it is required, stabilisation is performed by the orthopaedic team at Robert Debré Hospital, where a multidisciplinary consultation system (neurosurgery, orthopaedics, GI and urological surgery) has been in place for over 10 years.


Craniosynostosis is treated by remodelling or decompression procedures in the absence of complex craniofacial stenosis (Crouzon syndrome, Appert syndrome).


Treatment may be a ventriculoperitoneal shunt or a ventriculocisternostomy, depending on the nature of the condition.

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