The role of pharmaco-electroencephalographic monitoring in treatment of patients with resistant forms of epilepsy

Abstract

Continuous electroencephalography monitoring plays an important role in assessing the effect of anticonvulsant treatment. To illustrate this, an own clinical experience of continuous electroencephalography monitoring in a patient with giant subcortical-periventricular heterotopia at the stage of anticonvulsant selection is presented. A clinical case of symptomatic epilepsy as a result a giant subcortical-periventricular brain heterotopia was observed. Seizures were resistant to ongoing treatment. Epileptic seizure and coincident epileptic brain activity were registered for the first time in this patient only at continuous electroencephalography monitoring. On brain magnetic resonance imaging signs of giant subcortical-periventricular heterotopia of right frontal and temporal lobes were found. The combination of anticonvulsants was changed, allowing to achieve clinical remission, which was proved by repetitive electroencephalography after 7 months of treatment. The role of continuous electroencephalography monitoring to determine the effect of administered anticonvulsant treatment is shown. Heterotopias are a group of subcortical displasias - various maturation abnormality of the cerebral cortex, which are often associated with neurological deficits, onset as an epileptic seizure is characteristic. The particular feature of the presented case is minimal neurological deficit observed. The onset of epileptic seizures in the patient was at the age of 12 despite considerable morphologic brain changes.