John Libbey Eurotext

Epileptic Disorders

The Educational Journal of the International League Against Epilepsy

Epilepsy after cerebral infection: review of the literature and the potential for surgery Volume 19, numéro 2, June 2017

Illustrations

  • Figure 1
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Tableaux

Auteurs
1 Child Neurology,University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich
2 Swiss Epilepsy Center, Bleulerstrasse 60, 8008 Zurich, Switzerland
3 Neuropediatric Clinic and Clinic for Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schoen-Klinik Vogtareuth, Krankenhausstrasse 20, 83569, Vogtareuth, Germany
* Correspondence: Hans Holthausen Neuropediatric Clinic and Clinic for Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schoen-Klinik Vogtareuth, Krankenhausstrasse 20, 83569, Vogtareuth, Germany
  • Mots-clés : encephalitis, meningitis, epilepsy surgery, refractory, herpes, neurocysticercosis
  • DOI : 10.1684/epd.2017.0916
  • Page(s) : 117-36
  • Année de parution : 2017

The risk of unprovoked seizures in population-based cohorts of cerebral infection survivors is 7-8% in developed countries, rising to considerably higher rates in resource-poor countries. The main risk factors for epilepsy after cerebral infection, besides acute seizures, are infection-associated brain lesions and status epilepticus during the acute phase. Despite the high prevalence of pharmacoresistant epilepsies after cerebral infections, especially in patients with MRI-identifiable lesions, only a small minority undergoes epilepsy surgery. However, excellent surgical candidates are particularly those with a history of meningitis or encephalitis in early childhood, hippocampal sclerosis on MRI, as well as a history, seizure semiology, and EEG-findings compatible with the diagnosis of a mesial temporal lobe epilepsy syndrome. More challenging are patients with neocortical/extratemporal lobe epilepsies post cerebral infection. Finally, patients with a severe hemispheric injury with contralateral hemiparesis are candidates for hemispherectomy/hemispherotomy. This review attempts to shed some light on this frequent cause of symptomatic focal epilepsy, with an emphasis on the chances offered by epilepsy surgery.