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Emergency Surgery for Refractory Status Epilepticus.

Abhijeet Botre1, Vrajesh Udani, Neelu Desai

  • 1Departments of Pediatrics, *Pediatric Neurology and #Neurosurgery, PD Hinduja Hospital and Research Centre, Mumbai, India. Correspondence to: Dr Neelu Desai, Pediatric Neurologist, PD Hinduja Hospital and MRC, Veer Savarkar Marg, Mahim, Mumbai 400 016, India. neelushahdesai@gmail.com.

Indian Pediatrics
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Summary

Emergency hemispherotomy offers a viable treatment for pediatric refractory status epilepticus. This surgical intervention provides sustained seizure freedom in select cases with specific MRI and imaging findings.

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Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Refractory status epilepticus in children presents significant management challenges.
  • Current treatment options for pediatric status epilepticus are often limited.

Observation:

  • Two pediatric patients with medically refractory status epilepticus were identified.
  • Both patients exhibited lesional pathology on MRI with concordant EEG and PET scan data.

Findings:

  • Emergency hemispherotomy was performed in both cases.
  • Complete and sustained seizure freedom was achieved postoperatively in both children.

Implications:

  • Emergency surgery, specifically hemispherotomy, is a potential therapeutic option for pediatric refractory status epilepticus.
  • This approach is indicated in carefully selected cases with confirmed lesional pathology and corroborating imaging data.