A Case of Epilepsia Partialis Continua after Gamma Knife Radiosurgery / 대한간질학회지

ABSTRACT

The gamma knife radiosurgery (GKS) is a safe and effective neurosurgical approach in the treatment of arteriovenous malformation (AVM). Seizures after GKS are rarely reported, but epilepsia partialis continua (EPC) has not been reported yet. We report a patient with EPC accompanied with cerebral edema after GKS in AVM. A 50-year-old man was admitted for EPC, dysarthria and monoparesis 20 days after GKS due to AVM. Brain MRI showed increased cerebral edema around AVM in the left premotor area. Symptoms were relieved by IV dexamethasone and antiepileptic drugs (AEDs). 15 weeks later, EPC recurred and aphasia and right hemiplegia were rapidly aggravated. The follow up brain MRI showed markedly increased cerebral edema compared with previous MRI. EPC was well controlled by AEDs, but aphasia and hemiplegia were not responsive to IV dexamethasone until trying oral prednisolon. We think that cerebral edema induced by EPC, as a complication of GKR, might aggravate hemiparesis.