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Case Report: Late-Onset Lennox-Gastaut Syndrome Treated With Stereotactic Electroencephalography-Guided Radiofrequency Thermocoagulation Before Craniotomy

The onset of Lennox-Gastaut syndrome (LGS), a severe epilepsy syndrome, is typically before 8 years of age. Late-onset LGS (with onset in adolescence and adulthood) is relatively rare clinically and has some differences from classical LGS. Herein, we describe the case of a patient with late-onset LG...

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Autores principales: Li, Sixian, Cai, Xiaodong, Yao, Chen, Wang, Yuanqing, Xiao, Xiaohua, Yang, Huafeng, Yao, Yi, Chen, Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9251299/
https://www.ncbi.nlm.nih.gov/pubmed/35795791
http://dx.doi.org/10.3389/fneur.2022.857767
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author Li, Sixian
Cai, Xiaodong
Yao, Chen
Wang, Yuanqing
Xiao, Xiaohua
Yang, Huafeng
Yao, Yi
Chen, Lei
author_facet Li, Sixian
Cai, Xiaodong
Yao, Chen
Wang, Yuanqing
Xiao, Xiaohua
Yang, Huafeng
Yao, Yi
Chen, Lei
author_sort Li, Sixian
collection PubMed
description The onset of Lennox-Gastaut syndrome (LGS), a severe epilepsy syndrome, is typically before 8 years of age. Late-onset LGS (with onset in adolescence and adulthood) is relatively rare clinically and has some differences from classical LGS. Herein, we describe the case of a patient with late-onset LGS and provide a literature review of such cases. The patient had focal epilepsy onset at 8 years of age. After a 9-year evolution, he suffered seizures of different types and had a diagnosis of late-onset LGS. Drug treatment was ineffective. Nothing was found on stereotactic electroencephalography (SEEG) and magnetic resonance imaging (MRI) during the course of the disease. After the second presurgical evaluation, we found a suspicious focus on high-resolution structural MRI which was verified by SEEG at last. After SEEG-guided radiofrequency thermocoagulation (RFTC), his seizures were controlled, and his cognitive function and quality of living clearly improved. However, his seizures recurred 2 years later, and he underwent left occipital resection. Thereafter, his seizures have been controlled until now. This case emphasizes the importance of high-resolution structural MRI in the treatment of LGS. Furthermore, it suggests that late-onset LGS may be caused by focal lesions and evolve from focal epilepsy. Thus, characterizing the clinical symptoms and performing individualized electroencephalographic follow-up are both very important. Additionally, the clinical outcome in this case implies the value and limitations of RFTC in patients with epilepsy and a clear focal lesion. Moreover, this case further supports differences between late-onset and classical LGS in terms of clinical manifestation, cognitive changes, prognosis, and treatment.
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spelling pubmed-92512992022-07-05 Case Report: Late-Onset Lennox-Gastaut Syndrome Treated With Stereotactic Electroencephalography-Guided Radiofrequency Thermocoagulation Before Craniotomy Li, Sixian Cai, Xiaodong Yao, Chen Wang, Yuanqing Xiao, Xiaohua Yang, Huafeng Yao, Yi Chen, Lei Front Neurol Neurology The onset of Lennox-Gastaut syndrome (LGS), a severe epilepsy syndrome, is typically before 8 years of age. Late-onset LGS (with onset in adolescence and adulthood) is relatively rare clinically and has some differences from classical LGS. Herein, we describe the case of a patient with late-onset LGS and provide a literature review of such cases. The patient had focal epilepsy onset at 8 years of age. After a 9-year evolution, he suffered seizures of different types and had a diagnosis of late-onset LGS. Drug treatment was ineffective. Nothing was found on stereotactic electroencephalography (SEEG) and magnetic resonance imaging (MRI) during the course of the disease. After the second presurgical evaluation, we found a suspicious focus on high-resolution structural MRI which was verified by SEEG at last. After SEEG-guided radiofrequency thermocoagulation (RFTC), his seizures were controlled, and his cognitive function and quality of living clearly improved. However, his seizures recurred 2 years later, and he underwent left occipital resection. Thereafter, his seizures have been controlled until now. This case emphasizes the importance of high-resolution structural MRI in the treatment of LGS. Furthermore, it suggests that late-onset LGS may be caused by focal lesions and evolve from focal epilepsy. Thus, characterizing the clinical symptoms and performing individualized electroencephalographic follow-up are both very important. Additionally, the clinical outcome in this case implies the value and limitations of RFTC in patients with epilepsy and a clear focal lesion. Moreover, this case further supports differences between late-onset and classical LGS in terms of clinical manifestation, cognitive changes, prognosis, and treatment. Frontiers Media S.A. 2022-06-20 /pmc/articles/PMC9251299/ /pubmed/35795791 http://dx.doi.org/10.3389/fneur.2022.857767 Text en Copyright © 2022 Li, Cai, Yao, Wang, Xiao, Yang, Yao and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Li, Sixian
Cai, Xiaodong
Yao, Chen
Wang, Yuanqing
Xiao, Xiaohua
Yang, Huafeng
Yao, Yi
Chen, Lei
Case Report: Late-Onset Lennox-Gastaut Syndrome Treated With Stereotactic Electroencephalography-Guided Radiofrequency Thermocoagulation Before Craniotomy
title Case Report: Late-Onset Lennox-Gastaut Syndrome Treated With Stereotactic Electroencephalography-Guided Radiofrequency Thermocoagulation Before Craniotomy
title_full Case Report: Late-Onset Lennox-Gastaut Syndrome Treated With Stereotactic Electroencephalography-Guided Radiofrequency Thermocoagulation Before Craniotomy
title_fullStr Case Report: Late-Onset Lennox-Gastaut Syndrome Treated With Stereotactic Electroencephalography-Guided Radiofrequency Thermocoagulation Before Craniotomy
title_full_unstemmed Case Report: Late-Onset Lennox-Gastaut Syndrome Treated With Stereotactic Electroencephalography-Guided Radiofrequency Thermocoagulation Before Craniotomy
title_short Case Report: Late-Onset Lennox-Gastaut Syndrome Treated With Stereotactic Electroencephalography-Guided Radiofrequency Thermocoagulation Before Craniotomy
title_sort case report: late-onset lennox-gastaut syndrome treated with stereotactic electroencephalography-guided radiofrequency thermocoagulation before craniotomy
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9251299/
https://www.ncbi.nlm.nih.gov/pubmed/35795791
http://dx.doi.org/10.3389/fneur.2022.857767
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