International Journal of Pediatrics 3 (a) (b) Figure 3: T2W Axial ﬂair MRI images of a patient with Rasmussen’s encephlitis taken six months apart showing progression of disease. Table 1: Postoperative seizure outcome with followup. Engels Class I Class II Class III Class IV Description Complete seizure freedom >90% reduction in seizures 75–90% reduction in seizures No improvement or worsening after surgery variables between the groups. P < 0.05 (two tailed) was considered signiﬁcant and data was analyzed using SPSS (version 19). 3. Results 3.1. Demography. There were 34 children with a mean age of 7.9 years. There were 22 (64.7%) males and 12 (35.3%) females. The mean age of seizure onset was 3.8 years (range: from neonates to 12 years). The mean duration of epilepsy was 4 years (range: from 3 months to 14 years). 28 children (82.3%) had a seizure frequency of ≥2 episodes/day, while 11 (32.3%) had at least one episode of status epilepticus prior to surgery. Twenty-two of them (64.7%) were on more than two AEDs. Epilepsy was due to Rasmussen’s encephalitis (RE; n = 11) (Figure 3), infantile hemiplegia seizure syndrome (IHSS; n = 12) (Figure 4), hemimegalencephaly (HM; n = 3) (Figure 5), Sturge Weber syndrome (SWS; n = 4) (Figure 6), and postencephalitic sequelae (PES; n = 4) (Figure 7). Twenty-seven (79.4%) patients underwent PIH for lesions causing hemispheric epilepsy, and seven (20.6%) underwent PIPQ for lesions causing subhemispheric epilepsy. The mean followup was 30.5 months. 3.2. Seizure Outcome and Their Predictors. The seizure outcome after surgery was assessed by Engel’s classiﬁcation [4] and is described along with followup in Table 1. We N = 34 (100%) 31 (91.1%) 2 (5.8%) — 1 (3.1%) Mean followup (months) 32.3 18 — 24 Figure 4: T2W Axial ﬂair MRI image of a 3-year-old boy with infantile hemiplegia seizure syndrome (IHSS). recorded 11 variables and analyzed them to arrive at predictive variables of a complete seizure freedom. (Tables 2 and 3). We found that age of seizure onset (P = 0.03) and the etiology of the disease causing epilepsy (P = 0.007) were predictive variables for the same. An older age of seizure onset pointed to good seizure outcome following surgery. Patients with HM had the worst seizure outcome. Patients