Pediatria pre prax 5/2014

Catastrofic epilepsy. Case of child with hemisferectomy for hemimegaencephaly with pharmacoresistent epilepsy

Catastrophic forms of refractory epilepsy followed by subsequent severe epileptic encephalopathy warrant an early and aggressive treatment. Epileptic encephalopathy due to a large hemispheric anomaly requires often treatment by hemispherectomy. The aim of this surgical therapy is to protect the healthy hemisphere from malignant epileptic discharges. The authors present a case report of a 4 years old boy with a favourable course of catastrophic epilepsy caused by hemimegaencephaly who underwent hemispherectomy in the age of 7 months. Postoperatively is clinically dominant seizure freedom, mild hemiparesis, mild psychomotor retardation, however without severe cognitive impairment.

Keywords: catastrophic epilepsy, hemimegaencephaly, farmacoresistancy, epilepsia partialis continua, hemispherectomy.