title: Temporal lobectomy for refractory status epilepticus in a case of limbic encephalitis.
abstract: The authors report a case of status epilepticus secondary to limbic encephalitis that was successfully treated with temporal lobectomy. A 45-year-old woman presented in status epilepticus refractory to high-dose suppressive medical therapy. Magnetic resonance imaging of the brain showed T2- and FLAIR-weighted hyperintensities in the right temporal lobe, left and right frontal lobes, and pons. A lumbar puncture revealed normal findings. Continuous electroencephalography monitoring showed continued right temporal seizure activity. A paraneoplastic panel was positive for N-type voltage-gated calcium channels. Subsequent bronchial biopsy revealed small cell carcinoma of the lung. A right temporal lobectomy was performed due to refractory status, resulting in resolution of seizure activity and recovery of good neurological function. The authors describe their case and review the literature on surgical therapy for refractory status epilepticus and limbic encephalitis.
authors.affiliation: Department of Neurology, West Virginia University Hospital, Morgantown, West Virginia 26506-9180, USA. tweimer@hsc.wvu.edu
authors.forename: Tracy
authors.initials: T
authors.lastname: Weimer
authors.forename: Warren
authors.initials: W
authors.lastname: Boling
authors.forename: David
authors.initials: D
authors.lastname: Pryputniewicz
authors.forename: Adriana
authors.initials: A
authors.lastname: Palade
mesh_terms: D018288:Carcinoma, Small Cell / Q000556:secondary; D004569:Electroencephalography; D005260:Female; D006801:Humans; D020363:Limbic Encephalitis / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013226:Status Epilepticus / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D013702:Temporal Lobe / Q000473:pathology / Q000601:surgery*