AUTHOR=Liu Qingzhu , Wu Nan , Liu Chang , Yu Hao , Sun Yu , Wang Yao , Yu Guojing , Wang Shuang , Ji Taoyun , Liu Xiaoyan , Jiang Yuwu , Cai Lixin 

TITLE=Pediatric epilepsy surgery in patients with Lennox-Gastaut syndrome after viral encephalitis

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1097535

DOI=10.3389/fneur.2023.1097535

ISSN=1664-2295

ABSTRACT=Objective: To observe the curative effect and outcomes of surgical treatment of patients with LGS secondary to viral encephalitis.
Materials and methods: The clinical data of 4 patients with LGS secondary to viral encephalitis admitted to the Children's Epilepsy Center of Peking University First Hospital from January 2014 to March 2017 were analysed retrospectively. All 4 patients underwent standardized preoperative evaluation (long-term video EEG (VEEG), MRI, PET scan and a neuropsychological test) and surgical treatment. All patients were followed up at 1, 3, 6, 12 and 36 months after the operation, and EEG was performed. The postoperative efficacy was evaluated according to the Engle grading system.
Results: The four patients were treated with different surgical methods (right temporoparietal occipital disconnection, corpus callosotomy, left temporoparietal occipital disconnection, and left anterior temporal lobectomy). Postoperative pathological findings were epilepsy secondary to viral encephalitis. The epileptic seizures disappeared completely in one patient and were reduced by 80% in two patients after the operation; one patient's seizures were reduced by 50%. The median follow-up time of the 4 patients was 4 years (3-5 years). At the end of follow-up, there was 1 case of Engle I, 2 cases of Engle III and 1 case of Engle IV.
Conclusion: Preliminary observation shows that surgical treatment is a useful treatment for patients with LGS secondary to viral encephalitis, but patient screening and selection of surgical methods have a significant impact on the prognosis of the patients.