A 48-year-old man was diagnosed with refractory epilepsy and psychogenic nonepileptic seizures. Both diagnoses were confirmed by video-EEG monitoring. His MRI brain showed evidence of right hippocampal sclerosis. He was diagnosed to have depression and posttraumatic stress disorder (PTSD).
#1. What should be the therapy of choice?
Right Answer:
b) Right anterior temporal resection
- Epilepsy affects 10% of psychogenic nonepileptic seizures (PNES) patients. Some authors consider the presence of PNES a relative contraindication for surgical consideration. However, a few reports have demonstrated improvement of both epileptic and psychogenic seizures following surgical resection. Therefore, drug resistant epilepsy patients seeking to achieve seizure freedom must be considered for surgical options.
