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Abstract Objective Epilepsy surgery is widely accepted as an effective therapeutic option for carefully selected patients with drug‐resistant epilepsy (DRE). There is limited data on the outcome of epilepsy surgery, especially in pediatric patients from the Eastern Mediterranean region. Hence, we performed a retrospective study examining the outcomes of resective surgery in 53 pediatric patients with focal DRE. Methods Patients with focal DRE who had undergone epilepsy surgery were included in the present study. All patients underwent a comprehensive presurgical evaluation. Postoperative seizure outcomes were classified using the Engel Epilepsy Surgery Outcome Scale. Results After surgery, 33 patients (62.2%) were Class I according to the Engel classification of surgical outcomes; eight patients (15.0%) were Class II, 11 (20.7%) were Class III, and one (1.8%) was Class IV. The relationships of presurgical, surgical, and postsurgical clinical variables to seizure outcomes were compared. Older age at seizure onset, older age at the time of surgery, the presence of focal to bilateral tonic–clonic seizures, seizure duration over 2 minutes, unsuccessful treatment with three or fewer antiseizure medications, lesions confined to one lobe (as demonstrated via magnetic resonance imaging [MRI]), surgical site in the temporal lobe, and histopathology including developmental tumors were significantly linked to an Engel Class I outcome. A univariate analysis of excellent surgical outcomes showed that lateralized semiology, localized interictal and ictal electroencephalogram (EEG) discharges, lateralized single‐photon emission computed tomography and positron emission tomography findings, and temporal lobe resections were significantly related to excellent seizure outcomes. Significance The results of our study are encouraging and similar to those found in other centers around the world. Epilepsy surgery remains an underutilized treatment for children with DRE and should be offered early.

Introduction: Trigeminal schwannoma is a rare, benign, solitary tumor arising from the trigeminal nerve. Patients commonly present with symptoms such as facial pain and paraesthesia. Multiple approaches have been introduced to access the intracranial and infratemporal fossae. Case presentation: A 39-year-old female patient complains of a mild headache on the right side, with right vision and hearing loss, right facial weakness, and dysphagia. The CT and MRI indicated a large dumbbell-shaped mass extending across the right side of the skull base, from the middle cranial fossa to the infratemporal fossa. An endoscopic endonasal approach allows a more detailed view of the midline structures by drilling the pterygoid bone and dissecting the pterygoid muscle. Conclusion: The endonasal endoscopic approach is an excellent method for patients with trigeminal schwannoma in intracranial and infratemporal fossae. Familiarity with the microsurgical anatomy of the infratemporal fossa dissection techniques via anterior and lateral approaches helps provide the best results and achieve the goal of tumor removal with minimal morbidities.