John Libbey Eurotext

Successful surgical resection in non-lesional operculo-insular epilepsy without intracranial monitoring Volume 15, issue 2, June 2013


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Department of Neurology, Chisinau, Moldova, Department of Neurology, Lausanne, Department of Neurology, Geneva, Department of Neurosurgery, Lausanne, Department of Neuropaediatrics, Lausanne, Switzerland

Pre-operative assessment and surgical management of patients with non-lesional extratemporal epilepsy remain challenging due to a lack of precise localisation of the epileptic zone. In most cases, invasive recording with depth or subdural electrodes is required. Here, we describe the case of 6.5-year-old girl who underwent comprehensive non-invasive phase I video-EEG investigation for drug-resistant epilepsy, including electric source and nuclear imaging. Left operculo-insular epilepsy was diagnosed. Post-operatively, she developed aphasia which resolved within one year, corroborating the notion of enhanced language plasticity in children. The patient remained seizure-free for more than three years.