Presurgical evaluation and surgery in the pediatric age group are unique in challenges related to caring for the very young, range of etiologies, choice of appropriate investigations, and surgical procedures. Accepted standards that define the criteria for levels of presurgical evaluation and epilepsy surgery care do not exist. Through a modified Delphi process involving 61 centers with experience in pediatric epilepsy surgery across 20 countries, including low–middle‐ to high‐income countries, we established consensus for two levels of care. Levels were based on age, etiology, complexity of presurgical evaluation, and surgical procedure. Competencies were assigned to the levels of care relating to personnel, technology, and facilities. Criteria were established when consensus was reached (≥75% agreement). Level 1 care consists of children age 9 years and older, with discrete lesions including hippocampal sclerosis, undergoing lobectomy or lesionectomy, preferably on the cerebral convexity and not close to eloquent cortex, by a team including a pediatric epileptologist, pediatric neurosurgeon, and pediatric neuroradiologist with access to video‐electroencephalography and 1.5‐T magnetic resonance imaging (MRI). Level 2 care, also encompassing Level 1 care, occurs across the age span and range of etiologies (including tuberous sclerosis complex, Sturge‐Weber syndrome, hypothalamic hamartoma) associated with MRI lesions that may be ill‐defined, multilobar, hemispheric, or multifocal, and includes children with normal MRI or foci in/abutting eloquent cortex. Available Level 2 technologies includes 3‐T MRI, other advanced magnetic resonance technology including functional MRI and diffusion tensor imaging (tractography), positron emission tomography and/or single photon emission computed tomography, source localization with electroencephalography or magnetoencephalography, and the ability to perform intra‐ or extraoperative invasive monitoring and functional mapping, by a large multidisciplinary team with pediatric expertise in epilepsy, neurophysiology, neuroradiology, epilepsy neurosurgery, neuropsychology, anesthesia, neurocritical care, psychiatry, and nursing. Levels of care will improve safety and outcomes for pediatric epilepsy surgery and provide standards for personnel and technology to achieve these levels.

中文翻译：

---

建立小儿癫痫手术中心护理水平的标准：来自 ILAE 小儿癫痫手术工作组的报告

儿科年龄组的术前评估和手术在与照顾幼儿、病因范围、选择适当的调查和手术程序相关的挑战方面是独一无二的。不存在定义术前评估和癫痫手术护理水平的公认标准。通过涉及 20 个国家（包括中低收入和高收入国家）的 61 个具有儿科癫痫手术经验的中心的改良德尔菲流程，我们就两个级别的护理达成了共识。水平基于年龄、病因、术前评估的复杂性和手术程序。能力被分配到与人员、技术和设施相关的护理水平。当达成共识（≥75% 的一致性）时，就建立了标准。1 级护理由 9 岁及以上具有离散病变（包括海马硬化症）的儿童组成，接受肺叶切除术或病变切除术，最好在大脑凸面且不靠近雄辩的皮层，由包括小儿癫痫病专家、小儿神经外科医生和小儿神经放射科医生在内的团队提供可以使用视频脑电图和 1.5-T 磁共振成像 (MRI)。2 级护理，也包括 1 级护理，发生在与 MRI 病变相关的年龄跨度和病因范围内（包括结节性硬化症、Sturge-Weber 综合征、下丘脑错构瘤），这些病变可能是界限不清的、多叶的、半球状的或多灶性的，并包括具有正常 MRI 或病灶在/邻接雄辩皮层的儿童。可用的 2 级技术包括 3-T MRI、其他先进的磁共振技术，包括功能性 MRI 和扩散张量成像（牵引成像）、正电子发射断层扫描和/或单光子发射计算机断层扫描、脑电图或脑磁图的源定位，以及进行术​​中或术外侵入性监测和功能映射的能力，由在癫痫、神经生理学、神经放射学、癫痫神经外科、神经心理学、麻醉、神经重症监护、精神病学和护理方面拥有儿科专业知识的大型多学科团队组成。护理水平将提高小儿癫痫手术的安全性和结果，并为达到这些水平的人员和技术提供标准。正电子发射断层扫描和/或单光子发射计算机断层扫描，使用脑电图或脑磁图进行源定位，以及执行术中或术外侵入性监测和功能映射的能力，由在癫痫、神经生理学、神经放射学、癫痫方面具有儿科专业知识的大型多学科团队进行神经外科、神经心理学、麻醉、神经重症监护、精神病学和护理。护理水平将提高小儿癫痫手术的安全性和结果，并为达到这些水平的人员和技术提供标准。正电子发射断层扫描和/或单光子发射计算机断层扫描，使用脑电图或脑磁图进行源定位，以及执行术中或术外侵入性监测和功能映射的能力，由在癫痫、神经生理学、神经放射学、癫痫方面具有儿科专业知识的大型多学科团队进行神经外科、神经心理学、麻醉、神经重症监护、精神病学和护理。护理水平将提高小儿癫痫手术的安全性和结果，并为达到这些水平的人员和技术提供标准。由在癫痫、神经生理学、神经放射学、癫痫神经外科、神经心理学、麻醉、神经重症监护、精神病学和护理方面拥有儿科专业知识的大型多学科团队组成。护理水平将提高小儿癫痫手术的安全性和结果，并为达到这些水平的人员和技术提供标准。由在癫痫、神经生理学、神经放射学、癫痫神经外科、神经心理学、麻醉、神经重症监护、精神病学和护理方面拥有儿科专业知识的大型多学科团队组成。护理水平将提高小儿癫痫手术的安全性和结果，并为达到这些水平的人员和技术提供标准。