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Bilateral epilepsy surgery in a 4-year-old child
A Fogarasi1, M Neuwirth, M Hegyi
1Bethesda Children's Hospital, 1146 Budapest, Hungary. fogarasi@bethesda.hu
Neuropediatrics
|January 4, 2005
Summary
Bilateral epilepsy surgery can be effective for catastrophic epilepsy in children. A two-step occipital lobectomy successfully treated a four-year-old, achieving seizure freedom without significant deficits.
Area of Science:
- Pediatric Neurology
- Epilepsy Surgery
Background:
- Bilateral epilepsy surgery is rarely reported due to concerns about neurological deficits.
- Catastrophic epilepsy often presents complex challenges in pediatric patients.
Observation:
- A four-year-old child with amaurotic, catastrophic epilepsy due to bilateral occipital cortical dysplasia was evaluated.
- The patient underwent video-electroencephalography (EEG) monitoring and intraoperative electrocorticography.
Findings:
- A two-step bilateral occipital lobectomy was performed.
- While the first resection provided temporary seizure control, the second operation resulted in sustained seizure freedom at 20 months follow-up.
Implications:
- Epilepsy surgery can be a viable option for carefully selected pediatric patients with catastrophic epilepsy and bilateral epileptogenic lesions.
- This case suggests that bilateral procedures may be considered when the risk of additional postsurgical deficits is low.