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All Journal BALI MEDICAL JOURNAL (BMJ) Medicinus : Jurnal Kedokteran Eduvest - Journal of Universal Studies Magna Neurologica
Made Agus Mahendra Inggas, Made Agus Mahendra
Faculty of Medicine, Pelita Harapan University, Indonesia
Aerospace Engineering Computer Science & IT Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Journal : Magna Neurologica

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Pediatric Epilepsy Surgery in A Drug-Resistant Epilepsy Patient Aggravated by SARS-CoV-2: A Case Report Samudra, Edeline; Ketaren, Retno Jayantri; Inggas, Made Agus Mahendra
Magna Neurologica Vol. 3 No. 2 (2025): July
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v3i2.1882

Abstract

Introduction: Epilepsy is a manageable neurological disorder, but about one-third of cases are classified as drug-resistant epilepsy (DRE). DRE in pediatrics is more complex and may lead to cognitive function impairment, while surgery can offer seizure control in cases of focal DRE. Case: A 10-year-old male presented with a four-year history of recurrent seizures, thought to be caused by a left temporal cerebral cyst diagnosed five years earlier. During episodes, he experienced body stiffness, bilateral eye twitching, and drooling, with intact consciousness. After SARS-CoV-2 exposure, seizures became more frequent despite antiepileptic treatment, leading to partial resection of the left temporal lobe nine months later. Two years post epileptic surgery, he has become drug-responsive and achieved seizure control with symptomatic relief through medication. Discussion: Epilepsy is common in children, and DRE should be considered in cases of intractable epilepsy. Various factors can cause DRE, and in this patient, SARS-CoV-2 is thought to aggravate seizures by binding to ACE2 receptors in the central nervous system. This neural interaction may trigger reactive astrogliosis and neuroinflammation, disrupting the balance between glutamate and GABA levels. However, epilepsy surgery has been effective in improving the quality of life. Conclusion: Epilepsy surgery, either resective or non-resective surgery, is still rarely performed in Indonesia, while the management of DRE may require surgery. Although complete seizure freedom is not guaranteed, surgery can often convert DRE into a drug-responsive condition.
Co-Authors Amanah, Salma Rizqi Andi Asadul Islam Eka J. Wahjoepramono Elashry, Abdelrahman Ramadan Javaid, Sarmad Kantikha, I Made Ketaren, Retno Jayantri Markoni Markoni Nardiman, Nardiman Putra, Putu Surya Pradipta Hariantha Rhadika, Anadya Romano, Sultan Adhitya Samudra, Edeline Sri Maliawan Tanuwijaya, Andrew Wilbert Vivien Puspitasari, Vivien Wahyoepramono, Julianta Widyatmiko, Himawan Wijaya, Jeremiah Hilkiah