Abstract
Objective: Reports on bilateral epilepsy surgical interventions are anecdotal because of the possible neurological deficits caused by them.
Methods: We report on a four-year-old amaurotic child with catastrophic epilepsy due to bilateral occipital cortical dysplasia. After video-EEG monitoring and intraoperative electrocorticography he underwent a two-step bilateral occipital lobectomy.
Results: The first resection resulted in only temporary seizure cessation; however, he became seizure-free after the second operation (follow-up: 20 months).
Conclusion: Patients with catastrophic epilepsy due to bilateral epileptogenic lesions but without a high risk of additional postsurgical deficit may be good candidates for epilepsy surgery.
Key words
Occipital lobe epilepsy - intractable seizures - bilateral epilepsy surgery - children - focal cortical dysplasia
References
-
1 Aicardi J. Pediatric epilepsy surgery: how the view has changed. Tuxhorn I, Holthausen H, Boenigk H Pediatric Epilepsy Syndromes and Their Surgical Treatment. London; John Libbey 1998: 3-7
-
2
Boesebeck F, Schulz R, May T, Ebner A.
Lateralizing semiology predicts the seizure outcome after epilepsy surgery in the posterior cortex.
Brain.
2002;
125
2320-2331
-
3 Duchowny M, Harvey S A, Sperling M R, Williamson P D. Indications and criteria for surgical intervention. Engel JJ, Pedley TA Epilepsy: A Comprehensive Textbook. Philadelphia; Lippincott-Raven 1997: 1677-1685
-
4
Duchowny M S.
Pediatric epilepsy surgery: the widening spectrum of surgical candidacy.
Epileptic Disorders.
1999;
1
143-151
-
5
Fogarasi A, Boesebeck F, Tuxhorn I.
A detailed analysis of symptomatic posterior cortex seizure semiology in children younger than 7 years.
Epilepsia.
2003;
44
89-96
-
6
Hader W J, Mackay M, Otsubo H, Chitoku S, Weiss S, Becker L. et al .
Cortical dysplastic lesions in children with intractable epilepsy: role of complete resection.
J Neurosurg.
2004;
100
110-117
-
7 Inoue Y, Mihara T, Seino M. Timing of epilepsy surgery: its relevance for psychosocial rehabilitation. Tuxhorn I, Holthausen H, Boenigk H, Pediatric Epilepsy Syndromes and Their Surgical Treatment. London; John Libbey 1998: 76-84
-
8
Kloss S, Pieper T, Pannek H, Holthausen H, Tuxhorn I.
Epilepsy surgery in children with focal cortical dysplasia (FCD): results of long-term seizure outcome.
Neuropediatrics.
2002;
33
21-26
-
9 Lüders H O, Awad I. Conceptional considerations. Lüders HO Epilepsy Surgery. New York; Raven Press 1992: 51-62
-
10
Romanelli P, Najjar S, Weiner H L, Devinsky O.
Epilepsy surgery in tuberous sclerosis: multistage procedures with bilateral or multilobar foci.
J Child Neurol.
2002;
17
689-692
MD PhD András Fogarasi
Bethesda Children's Hospital
Bethesda Street 3
1146 Budapest
Hungary
Email: fogarasi@bethesda.hu