PURPOSE To determine the safety, in our practice, of allowing patient preference to influence the timing of antiepileptic drug (AED) reduction, once they became seizure-free after anterior temporal lobectomy (ATL). METHODS Thirty patients underwent anterior temporal lobectomy for medically intractable complex partial epilepsy at Loma Linda University Medical Center between December 1st 1991 a...

Hemimegalencephaly, a congenital brain malformation typically characterized by enlargement of one hemisphere, is frequently associated with intractable epilepsy. The authors report a case of a 12-month-old girl with hemimegalencephaly who underwent semiurgent hemispherectomy because of rapidly escalating seizures, arrested development, and associated encephalopathy. The brain tissue was examine...

Patients with a porencephalic cyst frequently develop intractable temporal lobe epilepsy (TLE). We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst. Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus. Temporal lobectomy brou...

Improved non-invasive localization of the epileptogenic foci prior to epilepsy surgery would improve surgical outcome in patients with partial seizure disorders. A critical component for the identification of the epileptogenic brain is the analysis of electrophysiological data obtained during ictal activity from prolonged intracranial recordings. The development of a noninvasive means to identi...

We describe the courses of treatment for epilepsies in two patients with semilobar type holoprosencephaly (HPE); a 5-year-old girl and 30-year-old man. Seizure semiology included eye fixation, upward or lateral gaze, horizontal vertical nystagmus, eyelid flutter, grinning facial distortion, which frequently evolved to generalized tonic convulsions. In both patients, ictal electroencephalography...

Corpus callosotomy (CC) has been employed in the management of intractable epilepsy since 1940’ and should be considered for patients with generalized falling seizures with physical injury, recurrent life-threatening generalized convulsive status epilepticus or atypical absence status’. CC is especially useful in improving seizure control in patients with tonic and atonic seizures3 and those wi...

In a 16-year-old female, clonazepam (CZP) changed randomly occurring intractable tonic seizures of frontal lobe origin to a few sleep seizures when used as an adjunctive therapy. The significance of this change in the seizure pattern is discussed with an explanation of possible pathophysiologic mechanism.

A patient with hemimegalencephaly and intractable epilepsy underwent a preoperative embolic hemispherectomy. A seizure-free interval of 1 year followed the embolization procedure. In addition, the procedure was thought to be beneficial in limiting blood loss during a subsequent surgical hemispherectomy.

PURPOSE Epileptic spasms (ES) beyond infancy are a highly refractory type of seizures that require the development of an effective treatment. We therefore studied the efficacy and safety of topiramate (TPM), which is a drug that is indicated to be effective for intractable childhood epilepsy, for ES. METHODS Out of 58 children with ES, we enrolled 33 patients treated with TPM at ≤ 12 years of...

Surgery for space occupying lesions of the brain associated with intractable epilepsy represents a special problem because relief of the epilepsy in as much an operative goal as excision of the space occupying lesion itself. This study concerns 32 patients with space occupying lesions and intractable epilepsy who underwent excision of the lesion with acute intraoperative electrocorticography gu...