Epilepsy & Behavior Reports (Jan 2022)

Epilepsy surgery in PCDH 19 related developmental and epileptic encephalopathy: A case report

  • Lakshmi Nagarajan,
  • Soumya Ghosh,
  • Jason Dyke,
  • Sharon Lee,
  • Jonathan Silberstein,
  • Dimitar Azmanov,
  • Warne Richard

Journal volume & issue
Vol. 19
p. 100560

Abstract

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We report a female child with PCDH19 related developmental and epileptic encephalopathy with drug-resistant seizures, cognitive and language impairment, autism spectrum disorder and sleep dysfunction. Her seizures, which started at 10 months of age, were resistant to multiple anti-seizure medications. Developmental stagnation followed by regression occurred after the onset of recurrent seizures. Her ictal EEGS suggested left temporal lobe origin for her recorded seizures. MRI upon expert re-review showed a subtle abnormality in the left temporal lobe.In view of the severe nature and frequency of her seizures, a left temporal lobectomy was undertaken at the age of 2 years and 3 months. Though her seizure outcome was Engel class 3, her seizure frequency and severity were significantly reduced. She has been seizure-free for 10 months at her last outpatient assessment when she was 4 years and 8 months of age (2 years and 5 months after epilepsy surgery). However she recently had an admission for COVID19 infection, with a breakthrough cluster of seizures. Her developmental trajectory changed, though she is making good progress with her cognitive and language skills.

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