scholarly journals Unexpected Aphasia following Right Temporal Lobectomy as Treatment of Recurrent Super-Refractory Status Epilepticus

2017 ◽  
Vol 9 (2) ◽  
pp. 195-203
Author(s):  
Utku Uysal ◽  
Patrick Landazuri ◽  
Caleb Pearson ◽  
Manoj Mittal ◽  
Nancy Hammond
Keyword(s):  
Status Epilepticus ◽  
Recovery Period ◽  
Refractory Status Epilepticus ◽  
Temporal Lobectomy ◽  
Effective Treatment Option ◽  
Modest Improvement ◽  
Refractory Status ◽  
Sensory Aphasia ◽  
Stepwise Reduction ◽  
Crossed Aphasia

Background: Super-refractory status epilepticus (SRSE) is a critical neurological condition with a high mortality rate. There are only limited data to direct the treatment in SRSE, and surgery has been reported to successfully stop SRSE. We present a case of recurrent SRSE treated with urgent right temporal lobectomy in a right-handed woman which potentially saved her life but resulted in crossed sensory aphasia. Case Description: A 61-year-old woman with a recent episode of prolonged focal SRSE due to right frontotemporal meningioma and hyperkalemia was admitted for recurrence of seizures that evolved to SRSE despite aggressive treatment with multiple fosphenytoin antiepileptic drugs (AEDs) and anesthetics. The patient underwent a right temporal lobectomy to remove the encephalomalacic and gliotic tissue around the meningioma that had been resected during a previous admission. Postoperatively the patient had a protracted course with modest improvement after stepwise reduction in her AEDs; however, her recovery unveiled a severe crossed aphasia. Conclusion: Resective surgery is an effective treatment option in the treatment of SRSE, although the recovery period can be protracted. Crossed aphasia after right temporal lobectomy should be considered in patients where it is not possible to complete a presurgical evaluation of higher cortical functions.

Temporal lobectomy for refractory status epilepticus in a case of limbic encephalitis

2008 ◽  
Vol 109 (4) ◽  
pp. 742-745 ◽  
Author(s):  
Tracy Weimer ◽  
Warren Boling ◽  
David Pryputniewicz ◽  
Adriana Palade
Keyword(s):  
Status Epilepticus ◽  
Limbic Encephalitis ◽  
Seizure Activity ◽  
Refractory Status Epilepticus ◽  
Temporal Lobectomy ◽  
Bronchial Biopsy ◽  
High Dose ◽  
Refractory Status ◽  
The Right ◽  
The Brain

The authors report a case of status epilepticus secondary to limbic encephalitis that was successfully treated with temporal lobectomy. A 45-year-old woman presented in status epilepticus refractory to high-dose suppressive medical therapy. Magnetic resonance imaging of the brain showed T2- and FLAIR-weighted hyperintensities in the right temporal lobe, left and right frontal lobes, and pons. A lumbar puncture revealed normal findings. Continuous electroencephalography monitoring showed continued right temporal seizure activity. A paraneoplastic panel was positive for N-type voltage-gated calcium channels. Subsequent bronchial biopsy revealed small cell carcinoma of the lung. A right temporal lobectomy was performed due to refractory status, resulting in resolution of seizure activity and recovery of good neurological function. The authors describe their case and review the literature on surgical therapy for refractory status epilepticus and limbic encephalitis.

Practical considerations for ketogenic diet in adults with super refractory status epilepticus

2020 ◽  
pp. 10.1212/CPJ.0000000000001009
Author(s):  
Neha Kaul ◽  
Joshua Laing ◽  
John-Paul Nicolo ◽  
Judy Nation ◽  
Patrick Kwan ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Ketogenic Diet ◽  
Diet Therapy ◽  
Refractory Status Epilepticus ◽  
Current Evidence ◽  
Dietary Therapy ◽  
Effective Treatment Option ◽  
Acute Setting ◽  
Refractory Status ◽  
Metabolic Interactions

ABSTRACTPURPOSE OF REVIEWKetogenic diet therapy can be utilized as an adjuvant treatment of super refractory status epilepticus (SRSE). However, the drug and metabolic interactions with concomitant treatments present a challenge for clinicians. In this review we focus on the practical considerations of implementing ketogenic dietary therapy in the acute setting, including the dietary composition, potential drug-diet interactions, and monitoring during ketogenic treatment.RECENT FINDINGSThis report describes the ketogenic diet therapy protocol implemented for the treatment of SRSE and a review of the current evidence to support clinical practice.SUMMARYThe control of SRSE is critical in reducing morbidity and mortality. There is emerging evidence that ketogenic diet may be a safe and effective treatment option for these patients.

Anterior Temporal Lobectomy for Refractory Status Epilepticus in Herpes Simplex Encephalitis

2016 ◽  
Vol 25 (3) ◽  
pp. 458-463 ◽  
Author(s):  
Sarah K. B. Bick ◽  
Saef Izzy ◽  
Daniel B. Rubin ◽  
Sahar F. Zafar ◽  
Eric S. Rosenthal ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Herpes Simplex ◽  
Herpes Simplex Encephalitis ◽  
Refractory Status Epilepticus ◽  
Temporal Lobectomy ◽  
Anterior Temporal Lobectomy ◽  
Refractory Status

scholarly journals How to Help Your Patients Enroll in the New-Onset Refractory Status Epilepticus (NORSE) and Febrile Infection-Related Epilepsy Syndrome (FIRES) Family Registry, and Other Rare Epilepsy Registries

2021 ◽  
pp. 153575972199832
Author(s):  
Karnig Kazazian ◽  
Marissa Kellogg ◽  
Nora Wong ◽  
Krista Eschbach ◽  
Raquel Farias Moeller ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Epilepsy Syndrome ◽  
Neurologic Disorder ◽  
Mortality And Morbidity ◽  
Refractory Status ◽  
Rigorous Research ◽  
Active Epilepsy ◽  
New Onset

New-onset refractory status epilepticus (NORSE) is a rare clinical presentation of refractory status epilepticus (RSE) that occurs in people without active epilepsy or preexisting neurologic disorder. Febrile infection-related epilepsy syndrome (FIRES) is a subcategory of NORSE. New-onset refractory status epilepticus/FIRES are becoming increasingly recognized; however, information pertaining to disease course, clinical outcomes, and survivorship remains limited, and mortality and morbidity are variable, but often high. The objective of the NORSE/FIRES Family Registry is to (1) provide an easily accessible and internationally available multilingual registry into which survivors or NORSE/FIRES surrogates or family members of people affected by NORSE/FIRES or their physicians can enter data in a systematic and rigorous research study from anywhere in the world where internet is available; and (2) to examine past medical history, outcomes, and quality of life for people affected by NORSE/FIRES.

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