Building and Expanding a Multidisciplinary Pediatric Epilepsy Surgery Program: Perspectives From a Children’s Hospital in an Underserved Area

Children with epilepsy commonly develop drug-resistant epilepsy, which often necessitates surgical intervention. Timely access to surgical intervention is critical for optimizing outcomes in these children. However, the significant undersupply of qualified epilepsy centers ensures that there remains a pressing need to expand and support pediatric epilepsy centers. This perspective article presents the development and expansion of our Pediatric Epilepsy Surgery Program in Kentucky. Overcoming initial obstacles such as limited infrastructure, staffing, and resources allowed us to implement strategic planning, acquire advanced neurosurgical and neurodiagnostic equipment, increase staff training, and establish subspecialty pediatric epilepsy clinics. Our program boasts several innovative technologies, including Visualase laser ablation, the Surgical Theater 3D visualization platform, responsive neurostimulation, deep brain stimulation, and robotic-assisted stereoelectroencephalography. Since its inception, our program has seen a substantial increase in surgical volume and has attained national recognition for its comprehensive and cutting-edge approach to pediatric epilepsy care. This article aims to describe the strategic development, infrastructure planning, staffing, clinical implementation, and outcomes of a pediatric epilepsy surgery program in a low-resource setting, offering a model for replication. This paper outlines the key steps involved in developing and expanding our Pediatric Epilepsy Surgery Program, which may serve as a valuable model for other institutions seeking to establish or grow their own pediatric epilepsy surgery programs, particularly in regions with limited access to comprehensive epilepsy care.