title: Acute Resective Surgery for the Treatment of Refractory Status Epilepticus.
abstract: BACKGROUND
  To identify the role of acute surgical intervention in the treatment of refractory status epilepticus (RSE).
  
  
  METHODS
  Retrospective review of consecutive patients who underwent epilepsy surgery from 2006 to 2015 was done to identify cases where acute surgical intervention was employed for the treatment of RSE. In addition, the adult and pediatric RSE literature was reviewed for reports of surgical treatment of RSE.
  
  
  RESULTS
  Nine patients, aged 20-68 years, with various etiologies were identified to have undergone acute surgical resection for the treatment of RSE, aided by electrocorticography. Patients required aggressive medical therapy with antiepileptic drugs and intravenous anesthetic drugs for 10-54 days and underwent extensive neurodiagnostic testing prior to resective surgery. Eight out of nine patients survived and five patients were seizure-free at the last follow-up. The literature revealed 13 adult and 48 pediatric cases where adequate historical detail was available for review and comparison.
  
  
  CONCLUSIONS
  We present the largest cohort of consecutive adult patients who underwent resective surgery in the setting of RSE. We also reveal that surgery can be efficacious in aborting status and in some can lead to long-term seizure freedom. Acute surgical intervention is a viable option in prolonged RSE and proper evaluation for such intervention should be conducted, although the timing and type of surgical intervention remain poorly defined.
authors.affiliation: Division of Epilepsy, Department of Neurology, Wayne State University School of Medicine, 4201 St Antoine, 8C UHC, Detroit, MI, 48201, USA. mmerhi@med.wayne.edu.
authors.forename: Maysaa Merhi
authors.identifier: http://orcid.org/0000-0003-1561-1667
authors.initials: MM
authors.lastname: Basha
authors.affiliation: Division of Epilepsy, Department of Neurology, Wayne State University School of Medicine, 4201 St Antoine, 8C UHC, Detroit, MI, 48201, USA.
authors.forename: Kushak
authors.initials: K
authors.lastname: Suchdev
authors.affiliation: Comprehensive Epilepsy Center, Yale University, New Haven, CT, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Dhakar
authors.affiliation: Division of Epilepsy, Department of Neurology, Wayne State University School of Medicine, 4201 St Antoine, 8C UHC, Detroit, MI, 48201, USA.|Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Kupsky
authors.affiliation: Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Mittal
authors.affiliation: Division of Epilepsy, Department of Neurology, Wayne State University School of Medicine, 4201 St Antoine, 8C UHC, Detroit, MI, 48201, USA.
authors.forename: Aashit K
authors.initials: AK
authors.lastname: Shah
mesh_terms: D000328:Adult; D000368:Aged; D000069279:Drug Resistant Epilepsy / Q000503:physiopathology / Q000601:surgery*; D000069280:Electrocorticography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult
keywords: Acute epilepsy surgery; Continuous EEG; De novo status epilepticus; Intracranial electrodes; Refractory status epilepticus