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Epilepsy surgery in COVID times—a unique conundrum
The COVID-19 pandemic has forced hospitals to prioritize admissions. Epilepsy surgeries have been postponed at most centers. As the pandemic continues with no definite end in sight in the near future, the question arises until when such patients should be denied appropriate treatment. A 12-year-old...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8036014/ https://www.ncbi.nlm.nih.gov/pubmed/33839899 http://dx.doi.org/10.1007/s00381-021-05048-4 |
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author | Agrawal, Mohit Tripathi, Manjari Samala, Raghu Doddamani, Ramesh Ramanujan, Bhargavi Chandra, P. Sarat |
author_facet | Agrawal, Mohit Tripathi, Manjari Samala, Raghu Doddamani, Ramesh Ramanujan, Bhargavi Chandra, P. Sarat |
author_sort | Agrawal, Mohit |
collection | PubMed |
description | The COVID-19 pandemic has forced hospitals to prioritize admissions. Epilepsy surgeries have been postponed at most centers. As the pandemic continues with no definite end in sight in the near future, the question arises until when such patients should be denied appropriate treatment. A 12-year-old child with left-sided Rasmussen’s encephalitis with drug refractory epilepsy (DRE) presented at the height of the pandemic, with worsening of seizure frequency from 4–5/day to 20/day, with new-onset epilepsia partialis continua. She demonstrated features of progressive cognitive decline. The pros and cons of operating during the pandemic were discussed with the parents by a multidisciplinary team. She underwent endoscopic left hemispherotomy. Postoperatively she became seizure free but developed hospital-acquired mild COVID infection for which she was treated accordingly. Chosen cases of severe DRE, as the one illustrated above, who are deemed to benefit from surgery by a multidisciplinary team of physicians, should be re-categorized into the most severe class of patients and scheduled for surgery as soon as possible. The risk benefit ratio of the seizures being mitigated by surgery on one hand and possibility of acquiring COVID infection during hospital stay has to be balanced and a decision made accordingly. |
format | Online Article Text |
id | pubmed-8036014 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-80360142021-04-12 Epilepsy surgery in COVID times—a unique conundrum Agrawal, Mohit Tripathi, Manjari Samala, Raghu Doddamani, Ramesh Ramanujan, Bhargavi Chandra, P. Sarat Childs Nerv Syst Case Report The COVID-19 pandemic has forced hospitals to prioritize admissions. Epilepsy surgeries have been postponed at most centers. As the pandemic continues with no definite end in sight in the near future, the question arises until when such patients should be denied appropriate treatment. A 12-year-old child with left-sided Rasmussen’s encephalitis with drug refractory epilepsy (DRE) presented at the height of the pandemic, with worsening of seizure frequency from 4–5/day to 20/day, with new-onset epilepsia partialis continua. She demonstrated features of progressive cognitive decline. The pros and cons of operating during the pandemic were discussed with the parents by a multidisciplinary team. She underwent endoscopic left hemispherotomy. Postoperatively she became seizure free but developed hospital-acquired mild COVID infection for which she was treated accordingly. Chosen cases of severe DRE, as the one illustrated above, who are deemed to benefit from surgery by a multidisciplinary team of physicians, should be re-categorized into the most severe class of patients and scheduled for surgery as soon as possible. The risk benefit ratio of the seizures being mitigated by surgery on one hand and possibility of acquiring COVID infection during hospital stay has to be balanced and a decision made accordingly. Springer Berlin Heidelberg 2021-04-10 2021 /pmc/articles/PMC8036014/ /pubmed/33839899 http://dx.doi.org/10.1007/s00381-021-05048-4 Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Case Report Agrawal, Mohit Tripathi, Manjari Samala, Raghu Doddamani, Ramesh Ramanujan, Bhargavi Chandra, P. Sarat Epilepsy surgery in COVID times—a unique conundrum |
title | Epilepsy surgery in COVID times—a unique conundrum |
title_full | Epilepsy surgery in COVID times—a unique conundrum |
title_fullStr | Epilepsy surgery in COVID times—a unique conundrum |
title_full_unstemmed | Epilepsy surgery in COVID times—a unique conundrum |
title_short | Epilepsy surgery in COVID times—a unique conundrum |
title_sort | epilepsy surgery in covid times—a unique conundrum |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8036014/ https://www.ncbi.nlm.nih.gov/pubmed/33839899 http://dx.doi.org/10.1007/s00381-021-05048-4 |
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