Focal resection for malignant partial seizures in infancy

Michael S. Duchowny, Trevor J. Resnick, Luis A. Alvarez, Glenn Morrison

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

There is little experience with excisional surgery for drug-resistant partial seizures in very young patients. We describe our experience with 5 infants under 1 year of age with malignant partial seizures and deteriorating developmental status. All were experiencing frequent daily seizures that did not respond to Ist-line antiepileptic medications at high therapeutic serum levels and considerable medication toxicity. Three infants had complete resection of epileptic tissue (frontal corticectomy and prefrontal lobectomy) and are seizure-free. Two underwent partial resection (lateral temporal lobectomy, frontal corticectomy with anterior callosotomy) and have experienced a significant reduction in seizure frequency. Surgery did not result in any significant neurologic deficit or lead to compromise of developmental status. From these data, we tentatively conclude that excisional surgery can be performed safely in selected infants with medically uncontrolled malignant partial seizures and may significantly improve long-term seizure status. Referral to a tertiary center specializing in early childhood epilepsy surgical evaluation may be considered in these circumstances.

Original languageEnglish (US)
Pages (from-to)980-984
Number of pages5
JournalNeurology
Volume40
Issue number6
DOIs
StatePublished - Jun 1990

ASJC Scopus subject areas

  • Clinical Neurology

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    Duchowny, M. S., Resnick, T. J., Alvarez, L. A., & Morrison, G. (1990). Focal resection for malignant partial seizures in infancy. Neurology, 40(6), 980-984. https://doi.org/10.1212/wnl.40.6.980