Surgical Management Of Porencephalic Cyst In Patients With Medically-Intractable Epilepsy

Abstract

Objective: To detect the ability of surgical management of porencephalic cyst to control intractable epilepsy. Methods: Five patients diagnosed with porencephalic cyst causing epilepsy that could not be controlled with adequate dosing of three anti-epileptic drugs were included in the study. The study included four males and one female. The age of the patients ranged from 9 to 23 with a mean of 16.4 years. All patients were submitted to complete general and neurological examination, laboratory and radiological investigations as well as Electroencephalography (EEG). The radiological investigations included tomography (CT) and magnetic resonance imaging (MRI) of the brain. Craniotomy was done for all cases with uncapping of the cyst; removing all the gliotic tissues with or without fenestration of the cyst to the lateral ventricles. Cases were followed-up for six months postoperatively. Results: Most cases were under 20 years old. Etiology of the porencephalic cyst included trauma, congenital, vascular insult as well as infection. The cysts were located in the frontal, parietal and the temporal lobes. All patients benefited from the surgery, four cases (80%) discontinued or reduced the dose of anti-epileptic drugs and one had epilepsy controlled with three anti-epileptic drugs. Conclusion: Surgical management of intractable epilepsy in porencephalic cyst patients is a valuable method for controlling epilepsy and should be resorted to in all indicated patients.