Successful neurosurgical treatment of childhood complex partial status epilepticus with focal resection |
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Authors: | Ng Yu-tze Kim Howard L Wheless James W |
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Institution: | Texas Comprehensive Epilepsy Program, Department of Neurology, University of Texas-Houston Medical School, Houston, Texas, USA. y2ng@chw.edu |
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Abstract: | The treatment of complex partial status epilepticus continues to be controversial, especially with regard to the intensity of the treatment. Medical therapy and drug-induced coma are sometimes required. Rarely this may not be effective. A healthy 4-year old girl was first seen in complex partial status epilepticus. She had a 1-year history of cryptogenic partial-onset seizures. Detailed magnetic resonance imaging (MRI) studies were normal. Her course was refractory to multiple medical therapies and multiple subpial transection (MST). An urgent epilepsy surgery evaluation resulted in a focal cortical resection being performed over the right mesial parietal region with resultant seizure freedom and no significant neurologic deficit 2 years later. This patient illustrates the need to consider occult focal cortical dysplasia as a cause of nonconvulsive status epilepticus (NCSE) in children, and if it is not responsive to medical management, the utility of performing an urgent epilepsy surgery evaluation. |
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Keywords: | Nonconvulsive status epilepticus epilepsy surgery Focal cortical dysplasia Seizures Focal resection |
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