Surgical treatment of focal symptomatic refractory status epilepticus with and without invasive EEG

Abstract

Purpose: Neurosurgery appears to be a reasonable alternative in carefully selected patients with refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE). We discuss the optimal timing of the surgery and the use of previous stereoelectroencephalography (SEEG) invasive evaluation. Methods: We identified 3 patients (two pediatric and one adult) who underwent epilepsy surgery because of RSE or SRSE from our epilepsy surgery database, one of them with previous SEEG. Results: Status epilepticus resolved acutely in all of them with no mortality and no substantial morbidity. At follow-up (median: 2 years), 1 patient was seizure-free, and 2 had significant improvement. Conclusion: Surgery should be considered in all cases of RSE and SRSE early in the course of the evolution of the disease.

Keywords

• Hemispherectomy
• Status epilepticus/surgery
• Invasive EEG
• Stereoelectroencephalography
• Refractory status epilepticus
• Super-refractory status epilepticus