Research and publications from the Children's Epilepsy Surgery Service

Great Ormond Street Hospital, in association with University College London Institute of Child Health, has a long tradition of evaluating new techniques in assessing children for surgery, gathering an evidence base towards optimising future patient care.

Current projects

Brain imaging

Key to an epilepsy surgery programme is ensuring accurate brain imaging. Several projects are underway utilising different forms of brain scanning and assessing their relative role in determining the best candidates for epilepsy surgery. This involves looking at new ways of visualising brain structure, as well as using MRI to localise language function and epileptic foci in combination with EEG (brain wave) assessment (

Long term outcomes

We are also continuing to look at children long term after their surgery, to look at outcomes from a seizure, learning and behaviour point of view. A new recently funded multicentre project will look at the role of using a ketogenic diet preoperatively in children with focal cortical dysplasia to see if we can improve the likelihood of postoperative seizure freedom. Research within the epilepsy surgery programme is part of a wider research programme in epilepsy, evaluating many different aspects, looking at causes, optimising timing of intervention and ultimately with a goal of improving long term outcomes in complex epilepsy (

Refereed articles

Varadkar SM, Bien CG, Kruse CA, Jensen FE, Bauer J, Pardo CA, Vincent A, Mathern GW, Cross JH. Rasmussens Encephalitis: Current Concepts & Therapeutic Advances Lancet Neurol in press

Croft LJ, Rankin, PM, Liégeois F, Banks T, Cross JH Vargha-Khadem, F. Baldeweg,T. To speak, or not to speak? The feasibility of imaging overt speech in children with epilepsy Epilepsy Research in press

Blümcke I, Thom M, Aronica E, Armstrong DD, Bartolomei F, Bernasconi A, Bernasconi N, Bien CG, Cendes F, Coras R, Cross JH, Jacques TS, Kahane P, Mathern GW, Miyata H, Moshé SL, Oz B, Özkara C, Perucca E, Sisodiya S, Wiebe S and Spreafico R International Consensus Classification of Hippocampal Sclerosis in Temporal Lobe Epilepsy: A Task Force Report from the ILAE Commission on Diagnostic Methods Epilepsia in press

Barba C, Jacques T, Kahane P, Polster T, Isnard J, Leijten FSS, OzkaraC , Tassi L, Giordano F, Castagna M , John A, Öz B, Salon C, Streichenberger N, Cross JH and Guerrini R. Epilepsy Surgery in Neurofibromatosis Type 1 Epilepsy Research in press

Pahs G, Rankin P, Cross JH, Croft L, Northam GB, Liegeois F, Greenway S, Harrison S, Vargha-Khadem F, Baldeweg T, Asymmetry of planum temporale constrains interhemispheric language plasticity in children with focal epilepsy Brain Epub ahead of print 10th September 2013

Boshuisen K, Arzimanoglou A, Cross JH, Uiterwaal C.S.P.M, Polster T, van Nieuwenhuizen O, Braun K.P.J. for the ‘TimeToStop’ study group. Timing of AED withdrawal does not influence long-term seizure outcome after paediatric epilepsy surgery. The ‘TimeToStop’ study. Lancet Neurol. 2012 Sep;11(9):784-91.

D’Argenzio L, Colonelli MC, Harrison S, Jacques TS, Harkness W, Scott RC, Cross JH. Seizure outcome after extratemporal epilepsy surgery in childhood Dev Med Child Neurol 2012;54(11):995-1000

Longaretti F, Dunkley C, Varadkar S, Vargha Khadem F, Boyd SG, Cross JH. Evolution of the EEG in children with Rasmussens Syndrome Epilepsia 2012; 53(9):1539-1545

Colonelli MC, Cross JH, Davidson S, D’Argenzio L, Hannan S, Harkness W, Heyman I. Psychopathology in children before and after surgery for extratemporal epilepsy. Dev Med Child Neurol 2012;54:521-526

Cormack F, Vargha Khadem F, Wood SJ, Cross JH, Baldeweg T. Memory in paediatric temporal lobe epilepsy: effects of lesion type and side Epilepsy Res 2012;98(2-3):255-259

Riney CJ, Chong WK, Clark CA , Cross JH Voxel based morphometry in children with intractable focal epilepsy: implications for surgical intervention European Journal of Radiology 2012;(81)6:1299-305

D’Argenzio L, Colonelli MC, Harrison S, Jacques TS, Harkness W, Scott RC, Cross JH. Cognitive outcome after extratemporal epilepsy surgery in childhood Epilepsia 2011;52:1966-1972

Blaublomme T, Ternier J, Romero C, St Pier K, D’Argenzio L, Pressler R, Cross H, Harkness W. Adverse events occurring during invasive EEG recordings in children Neurosurgery 2011;69(2 Suppl Operative):ons169-ons175

Skirrow C, Cross JH, Cormack F, Harkness W, Vargha-Khadem F, Baldeweg T. Long-term outcome after temporal lobe surgery in childhood: intellectual gains are correlated with brain volume change. Neurology 2011;76:1330-1337

Dunkley C, Kung J, Scott RC, Nicolaides P, Neville B, Aylett SE, Harkness W, Cross JH. Epilepsy surgery in children under 3 years Epilepsy Research 2011;93:96-106

Blümcke I, Thom M, Aronica E, Armstrong DD, Vinters HV, Palmini A, Jacques TS, Avanzini G, Barkovich AJ, Battaglia G, Becker A, Cepeda C, Cendes F, Colombo N, Crino P, Cross JH, Delalande O, Dubeau F, Duncan J, Guerrini R, Kahane P, Mathern G, Najm I, Ozkara C, Raybaud C, Represa A, Roper SN, Salamon N, Schulze-Bonhage A, Tassi L, Vezzani A, Spreafico R The clinicopathologic spectrum of focal cortical dysplasias: A consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission Epilepsia 2011;52(1):158-174

Thom, M, Mathern GW, Cross JH, Bertram EH. Mesial Temporal Lobe Epilepsy: How do we improve surgical outcome? Ann Neurol 2010;68:424–434

Liegeois F, Morgan AT, Stewart LH, Cross JH, Vogel AP, Vargha-Khadem F. Speech and oral motor profile after childhood hemispherectomy Brain & Language 2010; 114:126-134

Gaillard WD, Chiron C, Cross J Helen, Harvey A Simon , Kuzniecky R, Hertz-Pannier L, Gilbert Vezina L. Guidelines for imaging infants and children with recent-onset epilepsy Epilepsia. 2009;50(9):2147-53

Sisiodiya S, Fauser S, Cross JH, Thom M Focal Cortical Dysplasia Type II. Lancet Neurol 2009;8:830-843

Review articles

Follett P, Vora N, Cross JH ‘Paediatric Intractable Epilepsy Syndromes: changing concepts in diagnosis and management’ in Pediatric Epilepsy Surgery (Advances and Technical Standards in Neurosurgery ) 2012;39:45-60.

Jadhav T, Cross JH Surgical Approaches to Treating Epilepsy in Children Current Treatment Options in Neurology DOI 10.1007/s11940-012-0203-8

Gaillard WD, Cross JH, Duncan JS Stefan H and. Theodore WH. Epilepsy imaging study guideline criteria: Commentary on diagnostic testing study guidelines and practice parameters. Task Force on Practice Parameter Imaging Guidelines for the International League Against Epilepsy, Commission for Diagnostics Epilepsia 2011;52:1750-1756

Cross JH Epilepsy surgery in children; are we doing enough? Epilepsy Professional January 2011

Cross JH Epilepsy surgery in children- no longer a last resort Editorial, Dev Med Child Neurol 2010;52:111-112

Cross JH Epilepsy Surgery in Childhood Annals of Indian Academy of Neurology 2007;10:28-33

Cross JH Update on epilepsy surgery Annotation: Archives of Disease in Childhood 1999;81:356-359 UI: 10490446

Cross JH Considerations in the evaluation of children for epilepsy surgery Progress in Neurology and Psychiatry 1998; 2: 27-30

E Lectures

Hartmann AL, Cross JH. Timing of surgery in Rasmussen Syndrome: Is patience a virtue Epilepsy Currents, in press

Cross JH, Neville BGR.The Surgical Treatment of Landau Kleffner Syndrome Epilepsia. 2009;50 Suppl 7:63-7,

Cross H. Results of epilepsy surgery Epilepsia 2006:262

Cross JH Epilepsy Surgery in Childhood Epilepsia, 2002;43 s3:65-70 UI:12060008

Cross JH The place of surgery in the treatment of Infantile Spasms Epilepsia 2000; 41: s5

Cross JH The role of 99Tcm HMPAO SPECT in focal epilepsy of childhood. In: Aktuelle Neuropadiatrie,edited by E Boltshauser, B Schmitt and M Steinlin. Novartis Pharma Verlag Nurnberg 1997