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Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
Temporal lobectomy in acute complicated herpes simplex encephalitis: technical case report
Rocío Sánchez-Carpintero1, Sergio Aguilera, Miguel Idoate
1Department of Paediatrics, Paediatric Neurology Unit, University Clinic of Navarra, University of Navarra, Pamplona, Spain. rsanchezc@unav.es
Neurosurgery
|June 27, 2008
Summary
Herpes virus encephalitis in immunocompromised patients may resist acyclovir, requiring ganciclovir. Temporal lobectomy can be life-saving for uncal herniation, preventing epilepsy and cognitive deficits.
Area of Science:
- Neuroscience
- Infectious Diseases
- Neurosurgery
Background:
- Herpes virus encephalitis is a rare but severe complication in brain tumor patients undergoing immunosuppressive therapy.
- Acyclovir resistance can occur in immunocompromised individuals, necessitating alternative treatments.
Observation:
- A 6-year-old girl with a brainstem tumor developed herpes virus encephalitis with acyclovir-resistant seizures and uncal herniation.
- The patient's condition was refractory to standard antiviral treatment, highlighting the challenge of managing such infections.
Findings:
- Ganciclovir proved effective against the acyclovir-resistant herpes virus.
- Internal decompressive craniotomy, specifically a right temporal lobectomy, successfully reduced intracranial pressure and removed necrotic tissue.
Implications:
- Early suspicion of antiviral resistance is crucial for immunocompromised patients with herpes virus encephalitis.
- Temporal lobectomy can be a life-saving intervention for uncal herniation, effectively controlling seizures and potentially preventing long-term epilepsy with minimal cognitive sequelae.
