Surgical Treatment of Refractory Status Epilepticus in Children: Candidate Selection and Outcome

Vendrame, Martina; Loddenkemper, Tobias

doi:10.1016/j.spen.2010.06.011

Cited by 34 publications

(28 citation statements)

References 48 publications

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“…Importantly, only 3 patients required hemispherectomy. This finding contrasts with data in the literature review by Vendrame and Loddenkemper 34 in which 14 of 32 patients had a hemispherectomy while 13 patients had limited resections. The literature also included 2 patients with RSE successfully treated with acute vagus nerve stimulator placement.…”

Section: 2021contrasting

confidence: 86%

“…Vendrame and Loddenkemper's 34 assertion that the focal nature of abnormalities seen on EEG and/or anatomical studies is the best indicator of a good outcome was borne out in our series of cases. While we strongly believe that the extent of resection should be tailored to the epileptogenic zone precisely defined by EEG, we recognize that this is not always possible.…”

Section: 2021mentioning

confidence: 57%

“…Vendrame and Loddenkemper et al 34 recently reviewed the existing literature on children surgically treated for RSE and noted that surgery may be an option if there is strong evidence of electrographic and/or structural focal abnormality. The majority of patients had either generalized discharges or nonfocal lateralized electroencephalographic features.…”

Section: 2021mentioning

confidence: 99%

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Surgical treatment of refractory status epilepticus in children

Bhatia

Ahmad²,

Miller

et al. 2013

PED

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Object Refractory status epilepticus (RSE) is a life-threatening neurological emergency associated with high morbidity and mortality. Affected patients often require prolonged intensive care and can suffer multiple complications. Surgical intervention to control RSE is rarely used but can obviate the risks of prolonged seizures and intensive care treatment. Authors of the present study analyzed their experience with the surgical management of patients suffering from RSE. Methods The Epilepsy Surgery Database at Miami Children's Hospital was reviewed for patients who had undergone surgery for RSE. Clinical presentation, electrophysiological profile, radiological data, surgical details, and postoperative course were evaluated. Results Between 1990 and 2012, 15 patients underwent surgery for uncontrolled seizures despite high-dose medical suppressive therapy. The mean preoperative duration of status epilepticus was 8 weeks. Ictal SPECT and FDG-PET imaging in conjunction with intraoperative electrophysiological studies helped to outline the extent of resection. Surgical intervention controlled seizures in all patients and facilitated the transition out of intensive care. Adverse events related to a prolonged intensive care unit stay included sepsis and respiratory complications. Four patients had worsened neurological function, developing hemiparesis and dysphasia. There was no operative mortality. Conclusions Surgical intervention can successfully control refractory partial status epilepticus, prevent associated morbidity, and decrease intensive care unit stay. Ictal SPECT and PET are valuable in guiding resection.

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Section: 2021contrasting

confidence: 86%

Section: 2021mentioning

confidence: 57%

Section: 2021mentioning

confidence: 99%

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Surgical treatment of refractory status epilepticus in children

Bhatia

Ahmad²,

Miller

et al. 2013

PED

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“…Multiple subpial transections surgery is done in patients with localized epileptogenic areas, which are impossible to remove safely. In such cases, transections will be made in cerebral cortex to interrupt and disconnect the seizures generating area with the neighbouring parts of the brain without affecting the functions performed by those areas in brain [26][27][28][29][30][31][32][33] .…”

Section: Non-drug Therapies To Treat Epilepsymentioning

confidence: 99%

An Overview of Non-drug Therapies for the Treatment of Epilepsy

Yasam¹,

Jakki²,

Senthil³

et al. 2018

pharmaceutical-sciences

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Yasam, et al.: Epilepsy and Non-drug TherapiesEpilepsy is one of the most common neurological disorders, characterized by recurrent spontaneous seizures and a major health problem that affects around 1-2 % of the population worldwide. The treatment generally includes antiepileptic drug therapies. However, despite the development of various antiepileptic drugs, about a third of patients are resistant to current pharmacotherapies. Non-drug therapies are also expanding in an exciting and unprecedented way since in patients with drug resistance, non-drug therapies like surgeries; implantable devices and diet are playing a key role in improving the quality of patient's life. In this review, the current available non-drug therapies ranging from preclinical to clinical for controlling seizures in epileptic patients with drug resistance have been highlighted. Initial results from these therapies are quite promising, but considerable development is required before these treatments earn a place in the standard clinical care.

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“…Surgical approaches include focal cortical resections, hemispherectomies, multiple subpial transections, and rarely corpus callosotomy and vagus nerve stimulator implantation. Focal resective surgery is usually indicated in patients with localized brain lesions and electrographic evidence of ictal focal seizure onset (Vendrame & Loddenkemper, 2010). Defining the optimal moment to indicate surgery and which patients may benefit from a cortical resection or a palliative procedure is not easy.…”

Section: Status Epilepticusmentioning

confidence: 99%