title: Epilepsy surgery outcome in coexisting symptomatic refractory focal epilepsy and benign focal epilepsy of childhood.
abstract: Epilepsy surgery may successfully treat refractory symptomatic focal epilepsy in patients with coexisting benign focal epileptiform discharges. Reported here is the outcome after resective epilepsy surgery in three children with pharmacoresistant lesional focal epilepsy in whom seizures of benign focal epilepsy of childhood had been recorded. Two patients had left temporal epilepsy due to a malformation of cortical development; one of these had dual pathology, with additional ipsilateral hippocampal sclerosis. One child had catastrophic left hemispheric epilepsy due to left hemimegalencephaly. Frequent, habitual seizures of symptomatic epilepsy resolved after surgery (follow-up duration, 32-55 months); however, rare benign focal seizures of childhood have continued. These cases demonstrate that lesional pharmacoresistant focal epilepsy can be successfully treated with resective epilepsy surgery even when coexisting with benign focal epilepsy of childhood. During postoperative follow-up, careful documentation of breakthrough seizures due to benign focal epilepsy of childhood is important, so that these patients are not labeled as surgical failures.
authors.affiliation: Cleveland Clinic Epilepsy Center, Cleveland, Ohio, USA.
authors.forename: Tim
authors.initials: T
authors.lastname: Wehner
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Lachhwani
authors.forename: William
authors.initials: W
authors.lastname: Bingaman
authors.forename: Senay
authors.initials: S
authors.lastname: Haspolat
authors.forename: Ajay
authors.initials: A
authors.lastname: Gupta
authors.forename: Prakash
authors.initials: P
authors.lastname: Kotagal
authors.forename: Ingrid
authors.initials: I
authors.lastname: Tuxhorn
authors.forename: Elaine
authors.initials: E
authors.lastname: Wyllie
mesh_terms: D001921:Brain / Q000002:abnormalities; D002540:Cerebral Cortex / Q000002:abnormalities; D002648:Child; D004351:Drug Resistance; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000150:complications* / Q000601:surgery*; D017029:Epilepsy, Complex Partial / Q000601:surgery; D019305:Epilepsy, Rolandic / Q000150:complications* / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures; D013226:Status Epilepticus / Q000150:complications / Q000601:surgery; D016896:Treatment Outcome