Worsening seizures after surgery for focal epilepsy due to emergence of primary generalized epilepsy.
Our patient underwent right anteromesial temporal resection at 17 years of age for intractable complex partial seizures due to hippocampal sclerosis, and then developed juvenile myoclonic epilepsy after a change in medication. Postoperative seizures ceased after a change to valproate monotherapy. Our patient reminds us to remain aware that generalized and focal epilepsy may coexist as an unusual cause for surgical failure. We feel that these patients may still be favorable candidates for epileptic surgery, as long as the focal epileptogenic zone is amenable to resection and the generalized epilepsy appears to be readily controllable.
Department of Neurology, The Cleveland Clinic Foundation, OH 44195, USA.
B
B
Diehl
E
E
Wyllie
A D
AD
Rothner
W
W
Bingaman
D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage; D018450:Disease Progression; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004829:Epilepsy, Generalized / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D011183:Postoperative Complications; D013702:Temporal Lobe / Q000503:physiopathology / Q000601:surgery; D017211:Treatment Failure; D014635:Valproic Acid / Q000008:administration & dosage
D000927:Anticonvulsants; D014635:Valproic Acid