title: Surgical treatment for acute symptomatic refractory status epilepticus: a case report.
abstract: A previously healthy 10-year-old boy developed generalized convulsive status epilepticus following a mild febrile illness. Prolonged video-electroencephalographic monitoring revealed frequent right hemispheric electrographic seizures that were refractory to high-dose suppressive therapy. Ictal and interictal magnetoencephalography demonstrated dipole sources projecting from the right mesial temporal region. Diffusion-weighted imaging showed restricted diffusion involving the right hippocampus. Right anterior temporal lobectomy resulted in cessation of status epilepticus. At 1-year follow-up, he attends regular school and has infrequent nocturnal seizures on chronic antiepileptic drug therapy. Surgical treatment should be considered to stop status epilepticus in selected cases of acute symptomatic refractory status epilepticus with no preexisting epilepsy or magnetic resonance imaging abnormalities and may avoid the complications associated with prolonged high-dose suppressive therapy.
authors.affiliation: Division of Neurology The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Ismail S
authors.initials: IS
authors.lastname: Mohamed
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Otsubo
authors.forename: Katsumi
authors.initials: K
authors.lastname: Imai
authors.forename: Manohar
authors.initials: M
authors.lastname: Shroff
authors.forename: Rohit
authors.initials: R
authors.lastname: Sharma
authors.forename: Sylvester H
authors.initials: SH
authors.lastname: Chuang
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Donner
authors.forename: James
authors.initials: J
authors.lastname: Drake
authors.forename: O Carter
authors.initials: OC
authors.lastname: Snead
mesh_terms: D000208:Acute Disease; D038481:Anterior Temporal Lobectomy / Q000379:methods*; D002648:Child; D038524:Diffusion Magnetic Resonance Imaging; D004569:Electroencephalography; D006801:Humans; D015225:Magnetoencephalography / Q000379:methods; D008297:Male; D013226:Status Epilepticus / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*