Affiliations: Department of Pediatric Neurology, Virginia Commonwealth University Hospital, Richmond, VA, USA | Department of Neurosurgery, Virginia Commonwealth University Hospital, Richmond, VA, USA
Note:  *Corresponding author: Syndi A. Seinfeld, Pediatric Neurology Department, Virginia Commonwealth University, Address: Children's Pavilion, 1st floor, 1001 E. Marshall Street, PO Box 980211, Richmond, VA 23298, USA. Tel.: +1 804 828 0445; Fax: +1 804 828 6690; E-mail: [email protected]
Abstract: Epilepsy surgery is an option for many pediatric patients diagnosed with intractable seizures. Identifying pediatric patients that are candidates for surgery can be complicated. This case presented a 19-year-old female with intractable epilepsy who had chronic immune thrombocytopenic purpura and Dandy-Walker variant. The patient had previously been prescribed three appropriate anti-epileptic drugs and continued to experience seizures weekly. The patient had thrombocytopenia, which represented a potential for increased complications. The pre-operative work-up demonstrated heterotopias and dysplasias, which were felt to be the source of the focal onset seizures. She underwent focal resection and at the time of the last follow-up visit, the patient had been seizure free for 2 yr. The outcome of the patient exemplified the importance of evaluating patients with posterior fossa abnormalities for epilepsy surgery. The data in patients with Dandy-Walker variant is limited.
Keywords: Dandy-Walker malformation, seizures, ITP, resistant epilepsy, temporal lobe, children