Introduction:Resective surgery appears to be a viable treatment option in a small minority of patients with convulsive or nonconvulsive refractory super status (RSE) due to focal pathologies.

Materials: Review of medical charts.

Results:Patient 1: A previously healthy 8-year-old, right-handed girl started with stereotyped focal seizures at 6 y.  She was admitted with malignant status epilepticus. The electroencephalogram showed right temporal ictal activity. The magnetic resonance imaging (MRI) showed right fronto parietal moderated encephalic hemiatrophy  and amigadala and hypocampus T2 hiperintensity. She showed no response to multiple AEDs and ketogenic diet. After 15 days, epilepsy surgery was performed with StereoEEG to localize epileptogenic zone. We performed an anterior temporal lobectomy with resolution of status epilepticus, persisting with occasional seizures and no neurological deficit, 1.7 year after surgery.

Patient 2: 21 year old female, with focal epilepsy since she was born and right hemiparesis. She was admitted due to complex partial RSE 48h of evolution, treated with Phenobarbital, carbamazepine, phenytoin, clobazam. The Electroencephalogam showed bifrontal ictal activity. The MRI showed left fronto-parietal polimicrogiria. She did not respond to treatment with multiples AEDs. After 20 days we performed a left hemispherectomy.  She is seizure free with right hemiparesis since surgery, 6 months ago.

Conclusion:In both cases the surgery resolved RSE, allowing the discontinuation of anesthetic drugs in one patient. The surgery is a treatment option for RSE in children and adult with defined epileptogenic area.