Surgical treatment of two patients with infantile spasms in early infancy

Early surgery for catastrophic epilepsy may prevent developmental deterioration and minimize functional deficit resulting from the surgical procedure. We report two patients who had infantile spasms and underwent surgery for epilepsy in early infancy (younger than 6 months old). Magnetic resonance imaging showed cortical dysplasia in both patients. One patient underwent lesionectomy in the right perirolandic area at 49 weeks conceptional age (CA) and the other infant underwent left temporo-occipital disconnection at 45 weeks CA. Both showed Engel classification I and catch-up developmental progress. However, with the second patient, we were concerned about the high volume transfusion relative to her body weight during the extensive disconnection because of the patient's small blood volume. We discuss the benefits and potential risks of surgical treatment for intractable epilepsy in early infancy.