Yu-Tze Ng1, John F Kerrigan, Harold L Rekate. 1. Department of Pediatric Neurology, Barrow Neurological Institute, Phoenix, Arizona 85013, USA. y2ng@chw.edu
Abstract
OBJECT: The purpose of this study was to report the cases of five patients with status epilepticus who were treated successfully with neurosurgery. METHODS: Five children presented with refractory status epilepticus, including complex partial status epilepticus, epilepsia partialis continua and "status gelasticus." Multiple medical therapies had failed to control the seizures, and focal resection was performed. Seizures were fully controlled in four patients, and in one patient seizure frequency was reduced by more than 90%. CONCLUSIONS: Refractory status epilepticus is associated with a high mortality rate and by definition does not respond well to medical treatment, even optimal medical treatment. Neurosurgical treatment should be considered as another therapeutic option once medical management has failed, and neurosurgery should not necessarily be a last resort.
OBJECT: The purpose of this study was to report the cases of five patients with status epilepticus who were treated successfully with neurosurgery. METHODS: Five children presented with refractory status epilepticus, including complex partial status epilepticus, epilepsia partialis continua and "status gelasticus." Multiple medical therapies had failed to control the seizures, and focal resection was performed. Seizures were fully controlled in four patients, and in one patientseizure frequency was reduced by more than 90%. CONCLUSIONS: Refractory status epilepticus is associated with a high mortality rate and by definition does not respond well to medical treatment, even optimal medical treatment. Neurosurgical treatment should be considered as another therapeutic option once medical management has failed, and neurosurgery should not necessarily be a last resort.
Authors: Gretchen M Brophy; Rodney Bell; Jan Claassen; Brian Alldredge; Thomas P Bleck; Tracy Glauser; Suzette M Laroche; James J Riviello; Lori Shutter; Michael R Sperling; David M Treiman; Paul M Vespa Journal: Neurocrit Care Date: 2012-08 Impact factor: 3.210