Surgical treatment of focal symptomatic refractory status epilepticus with and without invasive EEG

Carolina Cuello-Oderiz; Marina Aberastury; Ana Gabriela Besocke; Jorge Sinner; Betiana Comas-Guerrero; Carlos Alberto Ciraolo; Maria Concepción Pasteris; Walter Horacio Silva; María Del Carmen García

doi:10.1016/j.ebcr.2015.08.005

Surgical treatment of focal symptomatic refractory status epilepticus with and without invasive EEG

Epilepsy Behav Case Rep. 2015 Sep 27:4:96-8. doi: 10.1016/j.ebcr.2015.08.005. eCollection 2015.

Authors

Carolina Cuello-Oderiz¹, Marina Aberastury², Ana Gabriela Besocke¹, Jorge Sinner³, Betiana Comas-Guerrero², Carlos Alberto Ciraolo⁴, Maria Concepción Pasteris⁵, Walter Horacio Silva², María Del Carmen García¹

Affiliations

¹ Department of Adult Neurology, Epilepsy Section, Italian Hospital of Buenos Aires, Argentina.
² Department of Child Neurology, Epilepsy Section, Italian Hospital of Buenos Aires, Argentina.
³ Department of Adult Critical Care, Italian Hospital of Buenos Aires, Argentina.
⁴ Department of Neurosurgery, Italian Hospital of Buenos Aires, Argentina.
⁵ Neurology Center, "Santa Elena", Salta, Argentina.

Abstract

Purpose: Neurosurgery appears to be a reasonable alternative in carefully selected patients with refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE). We discuss the optimal timing of the surgery and the use of previous stereoelectroencephalography (SEEG) invasive evaluation.

Methods: We identified 3 patients (two pediatric and one adult) who underwent epilepsy surgery because of RSE or SRSE from our epilepsy surgery database, one of them with previous SEEG.

Results: Status epilepticus resolved acutely in all of them with no mortality and no substantial morbidity. At follow-up (median: 2 years), 1 patient was seizure-free, and 2 had significant improvement.

Conclusion: Surgery should be considered in all cases of RSE and SRSE early in the course of the evolution of the disease.

Keywords: Hemispherectomy; Invasive EEG; Refractory status epilepticus; Status epilepticus/surgery; Stereoelectroencephalography; Super-refractory status epilepticus.