Epilepsy surgery in the first months of life: a large type IIb focal cortical dysplasia causing neonatal drug-resistant epilepsy

Borggraefe I, Tacke M, Gerstl L, Leiz S, Coras R, Blümcke I, Giese A, Ertl-Wagner B, Thiel C, Noachtar S, Peraud A (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Epileptic Disorders John Libbey Eurotext

Book Volume: 21

Pages Range: 122-127

Journal Issue: 1

DOI: 10.1684/epd.2019.1037

Abstract

Focal cortical dysplasia is a common cause of medically refractory epilepsy in infancy and childhood. We report a neonate with seizures occurring within the first day of life. Continuous video-EEG monitoring led to detection of left motor seizures and a right frontal EEG seizure pattern. Brain MRI revealed a lesion within the right frontal lobe without contrast enhancement. The patient was referred for epilepsy surgery due to drug resistance to vitamin B6 and four antiepileptic drugs. Lesionectomy was performed at the age of two and a half months, and histopathological evaluation confirmed the diagnosis of focal cortical dysplasia type IIb (FCD IIb). The patient is free of unprovoked seizures without medication (Engel Class I) and is normally developed at 36 months after surgery. The case study demonstrates that FCD IIb may cause seizures within the first day of life and that epilepsy surgery can be successfully performed in medically intractable patients with a clearly identifiable seizure onset zone within the first three months of life. Although radical surgery such as hemispherectomy and multi-lobar resections are over-represented in early infancy, this case also illustrates a favourable outcome with a more limited resection in this age group.

Authors with CRIS profile

Ingmar Blümcke Lehrstuhl für Neuropathologie Christian Thiel Medizinische Fakultät

Involved external institutions

Universitätsklinikum der Ludwig-Maximilians-Universität München DE Germany (DE) Universität Ulm DE Germany (DE) Klinikum Dritter Orden DE Germany (DE)

How to cite

APA:

Borggraefe, I., Tacke, M., Gerstl, L., Leiz, S., Coras, R., Blümcke, I.,... Peraud, A. (2019). Epilepsy surgery in the first months of life: a large type IIb focal cortical dysplasia causing neonatal drug-resistant epilepsy. Epileptic Disorders, 21(1), 122-127. https://dx.doi.org/10.1684/epd.2019.1037

MLA:

Borggraefe, Ingo, et al. "Epilepsy surgery in the first months of life: a large type IIb focal cortical dysplasia causing neonatal drug-resistant epilepsy." Epileptic Disorders 21.1 (2019): 122-127.

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