Urgent, resective surgery for medically refractory, convulsive status epilepticus

Refractory, convulsive status epilepticus has significant mortality and morbidity. Urgent resective surgery may be of benefit in selected cases where medical therapies have failed. At our institution, from January 1992 until December 2005, urgent resective surgery was performed in three children with medically refractory convulsive status epilepticus. The etiologies were microdysgenesis, focal cortical dysplasia, and bilateral Rasmussen's syndrome and cortical dysplasia. In two cases, surgery resulted in termination of status epilepticus. In all three cases, surgery permitted discontinuation of high-dose suppression therapy and allowed the patient to leave the intensive care unit, either by terminating status epilepticus or by providing important histopathological information about the nature of the underlying disease and prognosis.