Epileptic encephalopatis: is it avoidable?

Case presentation: Female, 8 years old, with onset of seizures at 2 months, evolving refractory epilepsy. The were characterized by behavioral arrest and vacant gaze, in addition to episodes loss tone head turn the right intense salivation. Patient has used topiramate, nitrazepam, carbamazepine valproate. On examination, he is moderately mentally retarded does not speak. Prolonged videoelectroencephalogram demonstrated focal cerebral hemisphere resonance image showed frontal cortical dysplasia associated occipital heterotopic nodule. Surgery was performed intraoperative monitoring. After complete resection lesion initial epileptiform discharges, a greater extension pattern observed, which became more diffuse each extension. At follow up patient persisted only discrete frequency reduction.