From Despair to Hope: Advancing Pediatric Epilepsy Surgery Through Global Collaboration

Pediatric epilepsy, especially in its drug-resistant form, presents one of neurological care’s most complex challenges. There are forms of epilepsy where seizures occur infrequently and may eventually resolve on their own without the need for intervention. In other cases, the condition requires ongoing medication and, in situations where epilepsy becomes drug-resistant and medications no longer help, surgery may offer a viable solution. For families, the diagnosis often comes with emotional turmoil and a sense of helplessness — particularly when standard medications fail. 

Despite progress in clinical care, stigma around epilepsy remains a significant barrier. Some families may hesitate to seek help or even conceal a child’s diagnosis out of fear or misunderstanding. This underscores the urgent need for broader public awareness about what epilepsy is, how it presents itself and the complete range of evidence-based treatment options available. The misconception that a child with epilepsy cannot lead a full and meaningful life is still far too common — and simply not true.

Thanks to advancements in surgical treatment and a renewed focus on global knowledge exchange, even the most difficult cases can move from uncertainty toward a real possibility of hope. Recently, an international partnership between Valley Children’s Hospital in Madera, California, and Wigmore Women’s and Children’s Hospital in Yerevan, Armenia, exemplifies how healthcare collaboration can help expand access to life-changing surgical interventions for children with drug-resistant epilepsy.

Strengthening Local Capacity Through Shared Expertise

Valley Children’s and Wigmore both recognize that collaboration is among the most effective ways to drive meaningful progress in pediatric care – enabling both institutions to share first-hand experiences, expand knowledge and improve patient outcomes through systems improvement. In 2023, Valley Children’s formalized a strategic partnership with Wigmore to put those beliefs into practice. The collaboration includes medical staff exchanges, hands-on mentorship, nursing education and quality improvement initiatives — all aimed at advancing specialized pediatric care in Armenia. 

One of the earliest and most impactful areas of this partnership so far has been in the treatment of drug-resistant pediatric epilepsy – a condition that presents unique surgical challenges and was previously underserved in Armenia. According to estimates, about 4,000 Armenian children have been diagnosed with epilepsy. However, the actual number may be even higher as many families continue to hide the diagnosis or avoid contacting specialists. 

In April 2025, neurosurgeons at Wigmore successfully performed operations on three children with this form of epilepsy — the youngest of them just 18 months. These surgeries reflected months of intensive training and preparation by the Wigmore team, with guidance from Valley Children’s physicians. The team prepared for months through remote case reviews, infrastructure assessments and clinical planning. The result: three successful procedures with no postoperative complications reported to date. 

The Value of Mentorship in Complex Care

The completion of these three surgeries marked a significant breakthrough for Armenia’s pediatric neurosurgical community. It introduced a pathway to care that previously required traveling abroad. For patients and families, this development opened the door to specialized care that had once felt out of reach. Since then, Wigmore has received numerous applications from parents seeking epilepsy surgery for their children, indicating a growing trust in and demand for local expertise.

“This is a very important development, not only for Wigmore, but for the advancement of Armenia’s overall healthcare system,” said Tatevik Koloyan, chief development officer at Wigmore Women’s and Children’s Hospital. “Often, skilled specialists visit Armenia to provide consultations, perform surgeries and then they leave. While this is undoubtedly valuable, for us the priority is to invest in such cooperation by educating and building a team of skilled specialists within the country.” 

As Tatevik mentions, an integral part of this kind of partnership is the active educational agenda, aimed at acquiring new skills and learning from the best international healthcare standards to further implement and adapt them locally.

This model is gaining traction because it addresses more than immediate clinical needs. It focuses on building systems: developing multidisciplinary care pathways, strengthening neurodiagnostic capabilities and investing in the education of physicians, nurses and allied staff.

One key factor to success in pediatric epilepsy surgery is hands-on mentorship. Surgical interventions in young children — particularly involving the brain — carry risks that require deep expertise and precise coordination. On-site mentorship from experienced epilepsy specialists, combined with structured follow-up training, help ensure both safety and skill transfer during global partnership visits.

“When performing complex neurosurgery in children, early intervention is often critical to preserve cognitive development,” said Dr. Cesar Santos, Valley Children’s Healthcare’s medical director of neurosciences. “Having experienced mentors on site lets teams act with confidence while building long-term surgical capacities.”

Looking Forward: A Scalable Model for Specialized Pediatric Care

This experience highlights a replicable model: pair-targeted surgical missions with long-term knowledge transfer, local infrastructure investment and patient-centered outreach. Over time, such initiatives can transform isolated interventions into enduring solutions, giving more children access to timely, effective care closer to home.

“The greatest success of this initiative is not just the surgeries performed, but the readiness it created in the local team,” said Heather Tripp, Valley Children’s Healthcare’s clinical nurse specialist in pediatric intensive care. “Now there is a foundation for continuing this work — and expanding it.”

As global healthcare systems grapple with rising demands for specialized pediatric services, initiatives like this offer a blueprint for equity and innovation. They demonstrate that, with the right partnerships, even small countries can begin to close gaps in care — not by outsourcing expertise, but by cultivating it at home.