Surgical treatment of late-onset post-traumatic partial seizures in a child.
BACKGROUND
Although post-traumatic epilepsy accounts for a small number of epileptic patients, it should not be underestimated since it primarily affects children and young adults and can result in psychosocial disability and death.


METHODS
We present the case of a 14-year-old girl referred to us because of refractory partial seizures. The patient had experienced a head trauma at the age of 6 months requiring surgical treatment due to a large right fronto-temporo-parietal extradural hematoma. She was discharged on phenytoin prophylactically. At the age of 4 she had her first partial seizure, characterized by left arm and leg tonic-clonic movements. Her physical examination revealed a subtle left brachiocrural hemiparesis and developmental delay. Several antiepileptic drugs were tried and seizure control was not achieved. They were occurring 8-10 times per day. The proposed surgical treatment was based on the consistent seizure semiology and on the affected area as identified by MRI and visible macroscopically to the neurosurgeon. At 9 years follow-up the patient is seizure free. Her motor skills are adequate for living a normal life.


CONCLUSIONS
We emphasize that selected patients may benefit from surgical treatment when epilepsy results from a trauma.
Department of Neurosurgery, Sanatorio Allende, Córdoba, Argentina.
Julio César
JC
Suárez
Juan Carlos
JC
Bulacio
Pedro
P
Armelini
Zenón Milciades
ZM
Sfaello
Juan Carlos
JC
Viano
Enrique J
EJ
Herrera
Lucrecia
L
Ballarino
Roberto
R
Bergallo
Maria S
MS
Suárez
D000293:Adolescent; D004834:Epilepsy, Post-Traumatic / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009493:Neurosurgery / Q000379:methods*; D011184:Postoperative Period; D016896:Treatment Outcome