Stereotactic Radiosurgery for Treatment of Operculoinsular Refractory Epilepsy After Incomplete Resection in a Child

Canh Duy Phan,1 Anh Tuan Dang,2 Van Anh Ton-Nu,3 Huu Son Nguyen,4 Nhu Hiep Pham1 1Oncology Center, Hue Central Hospital, Hue City, Vietnam; 2Neurology Department, National Hospital of Pediatrics, Ha Noi, Vietnam; 3Pediatric Department, Hue University of Medicine and Pharmacy - Hue University, Hue City, Vietnam; 4Pediatric Center, Hue Central Hospital, Hue City, VietnamCorrespondence: Van Anh Ton-NuPediatric Department, Hue University of Medicine and Pharmacy - Hue University, 06 Ngo Quyen St, Hue City, VietnamTel +84982066063Email tonnuvananh@huemed-univ.edu.vnAbstract: A 13-year-old right-handed girl had operculoinsular refractory epilepsy with several seizures per week after temporal lobe epilepsy surgery despite appropriate anticonvulsant therapy. Instead of reoperation, she underwent stereotactic radiosurgery (SRS), which was performed using a linac-based Elekta Axesse SRS machine with a marginal dose of 24 Gy (gross target volume: 6.67 cm3) in one fraction. Post-radiosurgery, she had no clinical or radiological complications. She was maintained on two anti-seizure medications following treatment (valproate and levetiracetam) and was seizure free at the time of this report (during four weeks after SRS). Monthly follow-up was planned for the evaluation of long-term outcomes. SRS may be a safe option for treating intractable focal epilepsy or recurrent epilepsy after surgery failure in children.Keywords: stereotactic radiosurgery, epilepsy, refractory, epilepsy surger