Case 1: 28 year old presented with focal status epilepticus, was found to have sero-negative encephalitis and right mesial temporal sclerosis. Status was aborted, but seizures continued despite 5 antiepileptic drugs (AED’s). He underwent right anterior temporal lobectomy and then Stereo EEG, followed by a right superior temporal gyrus resection. He had seizure recurrence after surgery, but is now seizure-free for three years on 5 AED’s (Engel Class I).
Case 2: 37 year old presented with seizures and was found to have sero-negative encephalitis. She had more frequent seizures, despite being on 3 AED’s and VNS. Stereo-EEG showed seizures arising from the left mesial temporal and right mesial frontal regions. She underwent left temporal lobectomy. Seizures recurred, but overall frequency significantly improved on 4 AED’s (Engel Class III).
Case 3: 29 year old presented with status epilepticus and was found to have sero-negative encephalitis. Status was stopped, but seizures continued despite 3 AED’s. Her seizure frequency increased to almost daily. Video-EEG monitoring and Stereo EEG showed seizures in bilateral fronto-temporal regions predominantly in left mesial temporal region. She had left temporal lobectomy, without improvement, requiring 4 AED’s (Engel Class IV).