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KMID : 1031120210110020146
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Journal of Epilepsy Research
2021 Volume.11 No. 2 p.146 ~ p.149
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Therapeutic Challenge in a Case of Recent Onset Refractory Cluster Seizures
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Sureshbabu Sachin
Padmanabhan Muralikrishnan Veleri
Alappat Jacob
Mohanlal Smilu
Janardhanan Sujith
Karunanidhi Sellam
Kannan Lakshminarayan
Nayak Dinesh
Shekhar Biju
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Abstract
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A dilemma exists in context to the timing of surgery in a case presenting with explosive onset seizures secondary to a focal cortical dysplasia (FCD). This case report highlights the challenges faced in the management of a 4-year-old child with recent onset cluster seizures refractory to anti-epileptic drugs. A 4-year-old girl presented with an acute onset of cluster seizures (up to 32 in a day), semiologically characterized by tonic upper limb extension and laughter lasting for few seconds with no response to multiple anti-epileptic drugs. The clinical, electrographic, neuroimaging and interictal positron emission tomography data were concordant and consistent with a left middle frontal gyrus dysplasia which was successfully resected under electrocorticographic guidance. Patient is seizure free at 2 months of follow up. (Engel Class 1). Surgical resection is feasible and potentially more effective in the early phase of clinical presentation of FCD.
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KEYWORD
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Drug resistant epilepsy, Focal cortical dysplasia, Electrocorticography
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