Bilateral epilepsy surgery in a 4-year-old child

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.