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Epilepsia. 2003 Mar;44(3):468-71.

Successful neurosurgical treatment of childhood complex partial status epilepticus with focal resection.

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  • 1Texas Comprehensive Epilepsy Program, Department of Neurology, University of Texas-Houston Medical School, Houston, Texas, USA. y2ng@chw.edu

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.

PMID:
12614407
[PubMed - indexed for MEDLINE]
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