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Neurocritical Care

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01-12-2017 | Original Article

Acute Resective Surgery for the Treatment of Refractory Status Epilepticus

Authors: Maysaa Merhi Basha, Kushak Suchdev, Monica Dhakar, William J. Kupsky, Sandeep Mittal, Aashit K. Shah

Published in: Neurocritical Care | Issue 3/2017

Abstract

Background

To identify the role of acute surgical intervention in the treatment of refractory status epilepticus (RSE).

Methods

Retrospective review of consecutive patients who underwent epilepsy surgery from 2006 to 2015 was done to identify cases where acute surgical intervention was employed for the treatment of RSE. In addition, the adult and pediatric RSE literature was reviewed for reports of surgical treatment of RSE.

Results

Nine patients, aged 20–68 years, with various etiologies were identified to have undergone acute surgical resection for the treatment of RSE, aided by electrocorticography. Patients required aggressive medical therapy with antiepileptic drugs and intravenous anesthetic drugs for 10–54 days and underwent extensive neurodiagnostic testing prior to resective surgery. Eight out of nine patients survived and five patients were seizure-free at the last follow-up. The literature revealed 13 adult and 48 pediatric cases where adequate historical detail was available for review and comparison.

Conclusions

We present the largest cohort of consecutive adult patients who underwent resective surgery in the setting of RSE. We also reveal that surgery can be efficacious in aborting status and in some can lead to long-term seizure freedom. Acute surgical intervention is a viable option in prolonged RSE and proper evaluation for such intervention should be conducted, although the timing and type of surgical intervention remain poorly defined.

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Title: Acute Resective Surgery for the Treatment of Refractory Status Epilepticus
Authors: Maysaa Merhi Basha
Kushak Suchdev
Monica Dhakar
William J. Kupsky
Sandeep Mittal
Aashit K. Shah
Publication date: 01-12-2017
Publisher: Springer US
Published in: Neurocritical Care / Issue 3/2017
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-017-0381-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Acute Resective Surgery for the Treatment of Refractory Status Epilepticus

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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