Background: Management of refractory status epilepticus in children is extremely challenging.
Case characteristics: Two children with medically refractory status epilepticus, both of whom had lesional pathology on MRI and concordant data on EEG and PET scan.
Intervention: Emergency hemispherotomy performed in both patients. A complete, sustained seizure freedom obtained postoperatively.
Message: Emergency surgery is a treatment option in selected cases of drug refractory status epilepticus with lesional pathology and concordant data.