Heuser Kjell, Romundstad Louis, Ivanovic Jugoslav, Egge Arild, Sætre Erik, Alfstad Kristin, Sveberg Line, Ulvin Line Bedos, Taubøll Erik
Department of Neurology, Oslo University Hospital, Oslo, Norway.
Department of Anesthesia and Intensive Care Medicine, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Epilepsy Behav Rep. 2024 Nov 17;28:100728. doi: 10.1016/j.ebr.2024.100728. eCollection 2024.
Status epilepticus (SE) is a critical medical emergency that demands immediate and effective intervention. We report a unique case involving a 21-year-old woman with left hemimegalencephaly who was hospitalized for super-refractory status epilepticus (SRSE) that persisted for 8 weeks. Despite extensive treatment efforts including multiple anti-seizure medications, anesthetics, high-dose methylprednisolone, anakinra, magnesium infusion, and a ketogenic diet, her condition remained unchanged. Ultimately, a left functional hemispherotomy was performed, informed by MRI findings and EEG results showing predominantly left-sided epileptic activity. This decision was made collaboratively when all other therapeutic options had been exhausted. Postoperatively, the patient recovered with manageable neurological deficits and a satisfactory quality of life. To our knowledge, this is the first reported case of acute functional hemispherotomy in an adult with hemimegalencephaly and SRSE.
癫痫持续状态（SE）是一种危急的医疗急症，需要立即进行有效干预。我们报告了一例独特病例，一名21岁患有左侧半侧巨脑症的女性因超难治性癫痫持续状态（SRSE）住院8周。尽管进行了广泛的治疗，包括多种抗癫痫药物、麻醉剂、大剂量甲基强的松龙、阿那白滞素、静脉输注镁和生酮饮食，但她的病情仍未改善。最终，根据MRI检查结果和脑电图结果显示主要为左侧癫痫活动，实施了左侧功能性大脑半球切除术。当所有其他治疗选择均已用尽时，共同做出了这一决定。术后，患者恢复，神经功能缺损可控，生活质量令人满意。据我们所知，这是首例报道的成年半侧巨脑症合并SRSE患者接受急性功能性大脑半球切除术的病例。
