Question
A child aged 12 and a half months experienced symptoms such as pursed lips, body arching backward, head tilting to the right, and crossed eyes four times from 20 to 30 days after birth. Starting at 7 months old, the child began experiencing grimacing, with about 20 to 30 episodes a day, and poor mental condition. Under the doctor’s recommendation, a 24-hour electroencephalogram (EEG) and brain CT scan were conducted, confirming the diagnosis of secondary epilepsy caused by brain development disorders. Currently, the child is taking Depakote 3 ml twice a day, which has extended the intervals between seizures and improved mental state during seizures. More recent seizures have shown exaggerated expressions such as clenched fists, but the mental state remains good. Recent blood concentration checks show that the medication is within normal range. However, the intervals between seizures have become shorter, and the child has developed a cold and cough.
Answer
According to the description, the child has secondary epilepsy caused by brain development disorders. Currently, medication control is not satisfactory, and surgical treatment may be considered to reduce the damage of epilepsy to the child’s brain earlier. Medication can only control symptoms, while surgery theoretically can cure the condition. However, not all patients are suitable for surgery; only 10-20% of patients can achieve satisfactory results through surgery. Therefore, strict preoperative evaluation is required to determine the feasibility of surgery. This includes magnetic resonance imaging (MRI) of seizure sequences and stereotactic electroencephalography (SEEG) with a pterional electrode to determine the location of the lesion. If the lesion is limited and located in a brain functional blind spot, surgical cure may be considered.