Epilepsy Surgery Due to Gliotic Scar Lesion in a Patient with Disconcordant Electroencephalogram Features

Abstract

Surgical evaluation should be considered in all patients with refractory focal epilepsy. However, surgical treatment may be neglected in patients with refractory epilepsy associated with scar lesions. This case report presents a 20-year-old woman with refractory seizures who presented with a sequel gliotic lesion in the left frontal region due to intracranial hemorrhage during infancy. The patient’s seizures were often hyperkinetic during sleep. She was evaluated as a surgical candidate because she had seizures 3-4 days a week under four antiseizure agents. The electroencephalogram revealed prominent interictal discharges in the contralateral hemisphere. Resective surgery was planned after discussion with the epilepsy surgery council. Frontal lobectomy was performed. The patient has been followed up for 5 months without seizures and motor deficits.

Keywords

• refractory
• focal
• epilepsy
• resective
• surgery