[P2-71] Reversible Mirror Focus in a Boy with Refractory Epilepsy Associated with Shaken Baby Syndrome
[Introduction]
Mirror focus is related to the kindling phenomena and is one of the evidence of progression in epilepsy. It also plays an important role in epilepsy surgery. Here we observed the existence of reversible secondary mirror focus in a boy with refractory epilepsy associated with shaken baby syndrome.
[Case Report]
A six-month-old boy, G3P2A1, full term, birth body weight 3082gm, who suffered from shaken baby syndrome, has seizures since 6 months of age. Neuroimaging showed severe right encephalomalacia and relative sparing of left hemisphere. Video-EEG monitoring showed right epileptogenic focus in first hospitalization at 1.5 years of age. He did not receive the surgery because of family hesitation. However, due to progressive decline of cognition and exacerbation of seizure, he came back for the re-evaluation again at 2.5 years of age. Interestingly, interictal left frontal discharges were found independently, and contralateral mirror focus was impressed. Video-EEG monitoring still lateralized to right hemisphere. The boy then received right hemispherectomy at 4 years of age. Postoperative condition showed great improvement. Seizure free has been noted for 6 years till now with improvement of cognition. Postoperative complication showed VP shunt implantation and mild hydrocephalus.
[Conclusions]
Reversible mirror focus was observed in a boy with refractory surgery, caused by shaken baby syndrome. Early surgical intervention achieved a good outcome of seizure free for 6 years. It might be suggested the benefit of early surgical in children with refractory epilepsy.
Mirror focus is related to the kindling phenomena and is one of the evidence of progression in epilepsy. It also plays an important role in epilepsy surgery. Here we observed the existence of reversible secondary mirror focus in a boy with refractory epilepsy associated with shaken baby syndrome.
[Case Report]
A six-month-old boy, G3P2A1, full term, birth body weight 3082gm, who suffered from shaken baby syndrome, has seizures since 6 months of age. Neuroimaging showed severe right encephalomalacia and relative sparing of left hemisphere. Video-EEG monitoring showed right epileptogenic focus in first hospitalization at 1.5 years of age. He did not receive the surgery because of family hesitation. However, due to progressive decline of cognition and exacerbation of seizure, he came back for the re-evaluation again at 2.5 years of age. Interestingly, interictal left frontal discharges were found independently, and contralateral mirror focus was impressed. Video-EEG monitoring still lateralized to right hemisphere. The boy then received right hemispherectomy at 4 years of age. Postoperative condition showed great improvement. Seizure free has been noted for 6 years till now with improvement of cognition. Postoperative complication showed VP shunt implantation and mild hydrocephalus.
[Conclusions]
Reversible mirror focus was observed in a boy with refractory surgery, caused by shaken baby syndrome. Early surgical intervention achieved a good outcome of seizure free for 6 years. It might be suggested the benefit of early surgical in children with refractory epilepsy.