Dominant, Lesional Pediatric-Onset Hemispheric Epilepsy

This chapter discusses a case of pharmacoresistant, progressive epilepsy due to pediatric-onset Rasmussen’s encephalitis and focal cortical dysplasia. The patient remained refractory despite medical and surgical interventions. We review the surgical considerations and outcomes in the pediatric population. We highlight technical considerations for neurostimulation device placement in pediatric patients. We describe neuroimaging and cerebrospinal fluid analysis findings in patients with Rasmussen’s encephalitis. This case also illustrates the use of quantitative electroencephalography during presentations with status epilepticus. Lastly, we discuss brief ictal rhythmic discharges and semiologies such as ictal nystagmus, cortical myoclonus, and epilepsia partialis continua.