Abolition of seizures following Forel-H-tomy for drug-resistant epilepsy: A case report

Epilepsia Open. 2023 Dec;8(4):1602-1607. doi: 10.1002/epi4.12826. Epub 2023 Sep 25.

Abstract

A 62-year-old female experienced an extensive cerebral contusion in the left frontotemporal lobe due to an acute subdural hematoma at the age of 44 years. Six months after the injury, the patient developed epileptic seizures. The seizures were generalized with right cervical rotation and fencing posture. Despite prescriptions for four antiepileptic drugs, partial seizures occurred several times a month and focal to bilateral tonic-clonic seizures once every 2 months. Video-electroencephalography showed epileptic discharges in the left frontal lobe. The patient was subsequently referred to our department for palliative surgery. The patient underwent a left Forel-H-tomy. The prescription of antiepileptic drugs was not changed, and the patient was seizure free for 1 year. Forel-H-tomy, a surgical procedure for intractable epilepsy, was pioneered by Dennosuke Jinnai. Despite its previously reported remarkable efficacy, Forel-H-tomy has not been performed for several decades. Nevertheless, it remains a potential alternative treatment option for drug-resistant epilepsy.

Keywords: fields of Forel; pallidothalamic tract; radiofrequency ablation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticonvulsants / therapeutic use
  • Drug Resistant Epilepsy* / drug therapy
  • Drug Resistant Epilepsy* / surgery
  • Electroencephalography / adverse effects
  • Epilepsy* / drug therapy
  • Female
  • Humans
  • Middle Aged
  • Seizures / drug therapy
  • Seizures / surgery

Substances

  • Anticonvulsants