Stereotactic Radiosurgery for Treatment of Operculoinsular Refractory Epilepsy After Incomplete Resection in a Child

Abstract

A 13-year-old right-handed girl had operculoinsular refractory epilepsy with several seizures per week after temporal lobe epilepsy surgery despite appropriate anticonvulsant therapy. Instead of reoperation, she underwent stereotactic radiosurgery (SRS), which was performed using a linac-based Elekta Axesse SRS machine with a marginal dose of 24 Gy (gross target volume: 6.67 cm³) in one fraction. Post-radiosurgery, she had no clinical or radiological complications. She was maintained on two anti-seizure medications following treatment (valproate and levetiracetam) and was seizure free at the time of this report (during four weeks after SRS). Monthly follow-up was planned for the evaluation of long-term outcomes. SRS may be a safe option for treating intractable focal epilepsy or recurrent epilepsy after surgery failure in children.

Keywords:

• stereotactic radiosurgery
• epilepsy
• refractory
• epilepsy surgery

Abbreviation

SRS, stereotactic radiosurgery; EEG, electroencephalography; MRI, magnetic resonance imaging; ECoG, electrocorticography.

Ethical Approval

Ethical approval to report this case was obtained from Hue Central Hospital Ethical Committee (approval number: 07-2020/NCKH-BVH).

Informed Consent

Written informed consents were obtained from the patient’s parents for their anonymized information to be published in this article.

Disclosure

The authors declare that they have no competing interests.

Additional information

Funding

No funding resources.