Stereotactic Radiosurgery For Treatment Of Operculoinsular Refractory Epilepsy After Incomplete Resection In A Child

A 13-year-old right-handed girl had operculoinsular refractory epilepsy with several seizures per week after temporal lobe epilepsy surgery despite appropriate antic-onvulsant 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 cm(3)) 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 after failure in children.