Palliative functional hemispherectomy for treatment of refractory status epilepticus associated with Alpers' disease
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Svetlana Lupashko & Saleem Malik & David Donahue & Angel Hernandez & M. Scott Perry
- چاپ و سال / کشور: 2011
Description
Purpose Palliative epilepsy surgery is considered for patients that would benefit from surgical therapy for intractable epilepsy but are not candidates for curative procedures. In many cases, the goals of therapy focus on improved quality of life more than seizure freedom.We discuss the use of epilepsy surgery for refractory status epilepticus, as well as the rationale and ethical considerations for employing a palliative procedure in otherwise fatal diseases. Methods We present a child with Alpers' disease presenting with refractory status epilepticus which was treated with functional hemispherectomy after failure of multiple typical therapies. Hemispherectomy allowed for the child to be extubated and ultimately discharged to home with her family. Unfortunately, the child died several months later after developing new-onset liver failure in the setting of a viral illness. Conclusion Functional hemispherectomy was effective for the treatment of refractory status epilepticus in Alpers' disease. We believe that the procedure resulted in improved quality of life which was the primary outcome goal. Palliative procedures should be considered in diseases with ultimate fatal outcome when the short-term benefits outweigh the risks. The ethical aspects of treatment must be carefully considered to insure treatment is provided in the best interest of the patient.
Childs Nerv Syst (2011) 27:1321–1323 DOI 10.1007/s00381-011-1495-9 Received: 4 March 2011 / Accepted: 18 May 2011 / Published online: 1 June 2011
