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Surgical treatment in super refractory status epilepticus related to arteriovenous malformation. Tratamiento quirúrgico en estado epiléptico super refractario relacionado con malformación arterio venosa.
Indexado
Scopus SCOPUS_ID:85151160596
DOI 10.4067/S0717-92272023000100078
Año 2023
Tipo

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



Introduction: Brain Arteriovenous Malformations (AVM)are an abnormalset ofdilatedarteries andveins within the brain and are characterized by loss of vascular organization with an abnormal arteriovenous shunt. The probability of AVM rupture is low, but it can cause deficits in up to 45% of patients. Epilepsy could be associated with AVM, and status epilepticus is rare. The evolution to refractory status epilepticus or super refractory status epilepticus (SRSE) is very rare. The objective is to present a patient with epilepsy associated with non-ruptured AVM, treated with embolization and a subsequent complication that evolves into SRSE, in which a favorable resolution was achieved after surgery. Clinical case: 70-year-old male, with a diagnosis of non-ruptured right temporal AVM and epilepsy, who has been seizure free since the diagnosis, is reported. Embolization of the AVM was performed, achieving total exclusion, after the procedure presented seizures that evolved into SRSE. After investigation, an AVM resection and partial resection of the ictal onset zone on the right parieto-temporal region was performed, including a disconnection of the central fronto-parietal region, where there was evidence of propagation of ictal activity. Patient recovered from the critical condition after surgery, and also presented electrographic normalization. After 2 years, the epilepsy is well controlled (Engel IIa). Discussion and conclusions: The surgical approach is an option in SRSE, and it should be proposed early on, within a reasonable time of evolution (1-2 weeks). The active approach in this case, where the surgery was done for SRSE control, was a successful intervention. Especially when the features are consistent -there is etiological evidence in imaging and electrical focality in studies- there can be a dramatic change in the prognosis.

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Disciplinas de Investigación



WOS
Neurosciences
Psychiatry
Scopus
Psychiatry And Mental Health
Surgery
Neurology (Clinical)
SciELO
Health Sciences

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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional



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Autores - Afiliación



Ord. Autor Género Institución - País
1 Garcia, Mariano Hombre Universidad Católica de Murcia - España
2 Acevedo, Hernán G. - Instituto de Neurocirugía Alfonso Asenjo - España
3 VENEGAS-SILVA, VIVIANA INES Mujer Instituto de Neurocirugía Alfonso Asenjo - España
4 Quintanilla, Felipe G. - Universidad de Chile - Chile
5 Mansilla, D. Hombre Instituto de Neurocirugía Alfonso Asenjo - España

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Financiamiento



Fuente
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