Successful treatment of super-refractory focal status epilepticus: Surgery, vagus nerve stimulation, and botox for epilepsia partialis continua

被引：0

作者：

Zalmay, N. ^{[1
]}

Nune, G. ^{[2
]}

Heck, C. N. ^{[2
]}

Dao, K. T. ^{[1
]}

Ly, B. T. ^{[1
]}

Ipe, J. ^{[1
]}

Liu, C. Y. ^{[2
]}

Veedu, H. P. Kunhi ^{[1
]}

机构：

[1] Kern Med Ctr, Bakersfield, CA 93306 USA

[2] Univ Southern Calif, Los Angeles, CA USA

来源：

EPILEPSY & BEHAVIOR REPORTS | 2025年 / 31卷

关键词：

Super-refractory status epilepticus; Surgical resection; Vagus nerve stimulation; Botulinum toxin therapy; Traumatic brain injury; Case report;

D O I：

10.1016/j.ebr.2025.100775

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Super-refractory status epilepticus (SRSE) is a life-threatening condition characterized by persistent seizures lasting beyond seven days despite anesthetic therapy. Managing SRSE is challenging, particularly in cases resistant to conventional treatments. This case report presents a 41-year-old female with prolonged SRSE secondary to focal epilepsy, successfully treated with surgical resection, vagus nerve stimulation (VNS), and botulinum toxin (BoNT) therapy. The patient initially presented with left focal motor status epilepticus and a right frontal intracerebral hematoma. Despite an emergency craniotomy, her seizures persisted, leading to prolonged SRSE. After multiple failed sedation weaning attempts, a stepwise intervention approach was implemented consisting of an Electrocorticography (ECoG)-guided surgical resection of the residual epileptic focus, VNS implantation for long-term seizure modulation, BoNT therapy for residual epilepsia partialis continua (EPC). The combined approach of surgical resection and VNS implantation successfully terminated the status epilepticus. Residual Epilepsia Partialis Continua (EPC) was effectively managed with botulinum toxin therapy (BoNT). This case underscores the potential efficacy of combining surgical resection and VNS implantation in treating SRSE and highlights the beneficial effects of BoNT in managing residual EPC, offering a potential treatment pathway for similar refractory cases.

引用

页数：6

共 11 条

[1]

[Anonymous], Surgical treatment of refractory status epilepticus in children Clinical article Sanjiv Bhatia, Faiz Ahmad, Ian Miller, V12, DOI [10.3171/2013.7.PEDS1388, DOI 10.3171/2013.7.PEDS1388]

[2] Sustained Effect of Botulinum Neurotoxin in Myoclonus Owing to Epilepsia Partialis Continua [J].