scholarly journals Corpus callosotomy for drug-resistant epilepsy in a pediatric patient with Waardenburg syndrome Type I

2021 ◽  
Vol 12 ◽  
pp. 217
Author(s):  
Takafumi Shimogawa ◽  
Nobutaka Mukae ◽  
Takato Morioka ◽  
Ayumi Sakata ◽  
Yasunari Sakai ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Type I ◽  
Drug Resistant ◽  
Waardenburg Syndrome ◽  
Corpus Callosotomy ◽  
Drop Attack ◽  
First Case ◽  
Lower Amplitude ◽  
Wave Bursts ◽  
Drug Resistant Epilepsy

Background: Waardenburg syndrome (WS) is caused by autosomal dominant mutations. Since the coexistence of epilepsy and WS type I is rare, the detailed clinical features and treatment of epilepsy, including surgery, have not been fully reported for these patients. We report the first case of an individual with WS type I, who underwent corpus callosotomy (CC) for drug-resistant epilepsy and obtained good seizure outcomes. Case Description: A boy was diagnosed as having WS type I and developmental delay based on characteristic symptoms and a family history of hearing loss. He underwent cochlear implantation at 18 months of age. At 4 years of age, he developed epileptic seizures with a semiology of drop attack. Electroencephalography (EEG) showed bilateral synchronous high-amplitude spikes and wave bursts, dominant in the right hemisphere. Based on the multimodality examinations, we considered that ictal discharges propagated from the entire right hemisphere to the left, resulting in synchronous discharge and a clinical drop attack; therefore, CC was indicated. At 9 years of age, he underwent a front 2/3rd CC. At 1 year, the patient became seizure free, and interictal EEG showed less frequent and lower amplitude spike and wave bursts than before. Conclusion: When patients with WS Type I and cognitive impairment show drug-resistant epilepsy, clinicians should consider a presurgical evaluation.

scholarly journals Rates and predictors of seizure outcome after corpus callosotomy for drug-resistant epilepsy: a meta-analysis

2019 ◽  
Vol 130 (4) ◽  
pp. 1193-1202 ◽  
Author(s):  
Alvin Y. Chan ◽  
John D. Rolston ◽  
Brian Lee ◽  
Sumeet Vadera ◽  
Dario J. Englot
Keyword(s):  
Meta Analysis ◽  
Palliative Surgery ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Drug Resistant ◽  
Corpus Callosotomy ◽  
Mri Findings ◽  
Drop Attacks ◽  
Drop Attack ◽  
Drug Resistant Epilepsy

OBJECTIVECorpus callosotomy is a palliative surgery for drug-resistant epilepsy that reduces the severity and frequency of generalized seizures by disconnecting the two cerebral hemispheres. Unlike with resection, seizure outcomes remain poorly understood. The authors systematically reviewed the literature and performed a meta-analysis to investigate rates and predictors of complete seizure freedom and freedom from drop attacks after corpus callosotomy.METHODSPubMed, Web of Science, and Scopus were queried for primary studies examining seizure outcomes after corpus callosotomy published over 30 years. Rates of complete seizure freedom or drop attack freedom were recorded. Variables showing a potential relationship to seizure outcome on preliminary analysis were subjected to formal meta-analysis.RESULTSThe authors identified 1742 eligible patients from 58 included studies. Overall, the rates of complete seizure freedom and drop attack freedom after corpus callosotomy were 18.8% and 55.3%, respectively. Complete seizure freedom was significantly predicted by the presence of infantile spasms (OR 3.86, 95% CI 1.13–13.23), normal MRI findings (OR 4.63, 95% CI 1.75–12.25), and shorter epilepsy duration (OR 2.57, 95% CI 1.23–5.38). Freedom from drop attacks was predicted by complete over partial callosotomy (OR 2.90, 95% CI 1.07–7.83) and idiopathic over known epilepsy etiology (OR 2.84, 95% CI 1.35–5.99).CONCLUSIONSThe authors report the first systematic review and meta-analysis of seizure outcomes in both adults and children after corpus callosotomy for epilepsy. Approximately one-half of patients become free from drop attacks, and one-fifth achieve complete seizure freedom after surgery. Some predictors of favorable outcome differ from those in resective epilepsy surgery.

scholarly journals Microsurgical endoscopy-assisted anterior corpus callosotomy for drug-resistant epilepsy in an adult unresponsive to vagus nerve stimulation

2016 ◽  
Vol 5 ◽  
pp. 27-30 ◽  
Author(s):  
Davide Nasi ◽  
Maurizio Iacoangeli ◽  
Lucia Di Somma ◽  
Mauro Dobran ◽  
Alessandro Di Rienzo ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Drug Resistant ◽  
Corpus Callosotomy ◽  
Drug Resistant Epilepsy

Developmental outcome after corpus callosotomy for infants and young children with drug-resistant epilepsy

2021 ◽  
Vol 117 ◽  
pp. 107799
Author(s):  
Ryoko Honda ◽  
Hiroshi Baba ◽  
Kohei Adachi ◽  
Rika Koshimoto ◽  
Tomonori Ono ◽  
...  
Keyword(s):  
Young Children ◽  
Developmental Outcome ◽  
Drug Resistant ◽  
Corpus Callosotomy ◽  
Drug Resistant Epilepsy ◽  
Infants And Young Children

Tailored multilobar disconnective epilepsy surgery in the posterior quadrant

2020 ◽  
Vol 132 (5) ◽  
pp. 1345-1357 ◽  
Author(s):  
Michele Rizzi ◽  
Martina Revay ◽  
Piergiorgio d’Orio ◽  
Pina Scarpa ◽  
Valeria Mariani ◽  
...  
Keyword(s):  
Safety Profile ◽  
Class I ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Type I ◽  
Drug Resistant ◽  
Presurgical Evaluation ◽  
Posterior Quadrant ◽  
Drug Resistant Epilepsy

OBJECTIVESurgical treatment of drug-resistant epilepsy originating from the posterior quadrant (PQ) of the brain often requires large multilobar resections, and disconnective techniques have been advocated to limit the risks associated with extensive tissue removal. Few previous studies have described a tailored temporoparietooccipital (TPO) disconnective approach; only small series with short postoperative follow-ups have been reported. The aim of the present study was to present a tailored approach to multilobar PQ disconnections (MPQDs) for epilepsy and to provide details about selection of patients, presurgical investigations, surgical technique, treatment safety profile, and seizure and cognitive outcome in a large, single-center series of patients with a long-term follow-up.METHODSIn this retrospective longitudinal study, the authors searched their prospectively collected database for patients who underwent MPQD for drug-resistant epilepsy in the period of 2005–2017. Tailored MPQDs were a posteriori grouped as follows: type I (classic full TPO disconnection), type II (partial TPO disconnection), type III (full temporooccipital [TO] disconnection), and type IV (partial TO disconnection), according to the disconnection plane in the occipitoparietal area. A bivariate statistical analysis was carried out to identify possible predictors of seizure outcome (Engel class I vs classes II–IV) among several presurgical, surgical, and postsurgical variables. Preoperative and postoperative cognitive profiles were also collected and evaluated.RESULTSForty-two consecutive patients (29 males, 24 children) met the inclusion criteria. According to the presurgical evaluation (including stereo-electroencephalography in 13 cases), 12 (28.6%), 24 (57.1%), 2 (4.8%), and 4 (9.5%) patients received a type I, II, III, or IV MPQD, respectively. After a mean follow-up of 80.6 months, 76.2% patients were in Engel class I at last contact; at 6 months and 2 and 5 years postoperatively, Engel class I was recorded in 80.9%, 74.5%, and 73.5% of cases, respectively. Factors significantly associated with seizure freedom were the occipital pattern of seizure semiology and the absence of bilateral interictal epileptiform abnormalities at the EEG (p = 0.02). Severe complications occurred in 4.8% of the patients. The available neuropsychological data revealed postsurgical improvement in verbal domains, whereas nonunivocal outcomes were recorded in the other functions.CONCLUSIONSThe presented data indicate that the use of careful anatomo-electro-clinical criteria in the presurgical evaluation allows for customizing the extent of surgical disconnections in PQ epilepsies, with excellent results on seizures and an acceptable safety profile.

scholarly journals Anterior corpus callosotomy in patients with drug-resistant epilepsy: Invasive EEG findings and seizure outcomes

2018 ◽  
Vol 9 ◽  
pp. 12-18 ◽  
Author(s):  
Olga Taraschenko ◽  
Swetha Pedavally ◽  
Kaeli K. Samson ◽  
Mark J. Puccioni ◽  
Deepak Madhavan
Keyword(s):  
Drug Resistant ◽  
Corpus Callosotomy ◽  
Drug Resistant Epilepsy

scholarly journals Respuesta cardiovascular al estrés en pacientes con epilepsia farmacorresistente: datos preliminares

2021 ◽  
Vol 37 (3) ◽  
pp. 440-448
Author(s):  
Alejandro Lozano-García ◽  
Judit Catalán ◽  
Kevin Hampel ◽  
Vicente Villanueva ◽  
Esperanza González-Bono ◽  
...  
Keyword(s):  
General Population ◽  
Cognitive Performance ◽  
Neuropsychological Assessment ◽  
Right Hemisphere ◽  
Cardiovascular Response ◽  
Suitable Model ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
Cognitive Stressor ◽  
The Relationship

El estrés es un factor de riesgo para las enfermedades cardiovasculares en la población general. La epilepsia se ha considerado un modelo adecuado de estrés crónico, con mayor incidencia de mortalidad cardiovascular que la población general. Este estudio proporciona datos preliminares sobre la respuesta cardiovascular ante un estresor cognitivo y una evaluación neuropsicológica en pacientes con epilepsia, explorando las relaciones entre la respuesta cardiovascular y el rendimiento cognitivo dependiendo del hemisferio responsable de la epilepsia. Treinta y cinco pacientes con epilepsia farmacorresistente, 17 con el área epileptógena(AE) en el hemisferio izquierdo (LH) y 18 con AE en el hemisferio derecho (RH), se sometieron a un estres cognitivo y una evaluación neuropsicológica. La respuesta cardiovascular se registró durante toda la sesión en ambas condiciones. Los resultados mostraron que una evaluación neuropsicológica de larga duración fue capaz de producir una respuesta cardiovascular modulada por el hemisferio, con disminuciones de la frecuencia cardíaca (y aumentos del intervalo RR) más pronunciadas en el período post-evaluación en pacientes con epilepsia del HI que en pacientes con epilepsia del HD (p = .05, p = .01, respectivamente). El hemisferio del AE moderó la relación entre la respuesta cardiovascular y el rendimiento cognitivo (para todos, p < .03). Nuestros hallazgos podrían tener implicaciones clínicas desde una perspectiva preventiva, ya que sugieren que el hemisferio del AE podría ser un factor relevante en el afrontamiento del estrés en personas con epilepsia farmacorresistente. Stress is a risk factor for cardiovascular diseases in the general population. Epilepsy has been considered a suitable model of chronic stress with a higher incidence of cardiovascular mortality than the general population. This study provides preliminary data about cardiovascular response to a cognitive stressor and a neuropsychological assessment in patients with epilepsy. It also explores the relationship between cardiovascular response and cognitive performance, depending on the side of seizure focus. Thirty-five patients with drug-resistant epilepsy, 17 with epileptogenic area (EA) in the left hemisphere (LH) and 18 with EA in the right hemisphere (RH), underwent a cognitive stressor and a neuropsychological assessment. The cardiovascular response was recorded throughout both conditions. Results showed that a long-lasting neuropsychological assessment was capable of producing a hemisphere-modulated cardiovascular response with heart rate (HR) decreases (and R-R interval increases) more pronounced in the LH patients than in the RH patients at the post-assessment period (p = .05 and p = .01, respectively). The hemisphere of EA moderated the relationship between cardiovascular response and cognitive performance (for all, p < .03). Our findings may have clinical implications from a preventive perspective since the EA hemisphere may be a relevant factor for coping with stress in people with drug-resistant epilepsy.

scholarly journals Corpus callosotomy for treatment of drug-resistant epilepsy: a review of 16 pediatric cases in northern Vietnam

2020 ◽  
Vol 25 (6) ◽  
pp. 582-587
Author(s):  
Nguyen Duc Lien ◽  
Dang Anh Tuan ◽  
Cao Vu Hung ◽  
Jacob R. Lepard ◽  
Brandon G. Rocque
Keyword(s):  
Neurological Deficits ◽  
Seizure Outcome ◽  
Drug Resistant ◽  
Imaging Findings ◽  
Corpus Callosotomy ◽  
Resource Limited Settings ◽  
Resource Limited ◽  
Drug Resistant Epilepsy ◽  
Postoperative Seizure

OBJECTIVEThe aim of this study was to evaluate postoperative seizure outcome in children with drug-resistant epilepsy not eligible for focal resection who underwent corpus callosotomy.METHODSThe study included 16 patients undergoing corpus callosotomy between September 2015 and May 2018. Seizure semiology and frequency, psychomotor status, and video electroencephalography and imaging findings were evaluated for all patients.RESULTSOf the 16 patients who underwent callosotomy during the study period, 11 underwent complete callosotomy and 5 underwent anterior only. Seizure improvement greater than 75% was achieved in 37.5% of patients, and another 50% of patients had seizure improvement of 50%–75%. No sustained neurological deficits were observed in these patients. There were no significant complications. Duration of postoperative follow-up ranged from 12 to 44 months.CONCLUSIONSCorpus callosotomy is an effective treatment for selected patients with drug-resistant epilepsy not eligible for focal resection in resource-limited settings. Fostering and developing international epilepsy surgery centers should remain a high priority for the neurosurgical community at large.

Corpus Callosotomy for Childhood-Onset Drug-Resistant Epilepsy Unresponsive to Vagus Nerve Stimulation

2014 ◽  
Vol 51 (6) ◽  
pp. 800-805 ◽  
Author(s):  
Ravindra Arya ◽  
Hansel M. Greiner ◽  
Paul S. Horn ◽  
Michele Turner ◽  
Katherine D. Holland ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Drug Resistant ◽  
Childhood Onset ◽  
Corpus Callosotomy ◽  
Drug Resistant Epilepsy

scholarly journals Case Report: Corpus Callosotomy in a Cat With Drug-Resistant Epilepsy of Unknown Cause

2021 ◽  
Vol 8 ◽  
Author(s):  
Daisuke Hasegawa ◽  
Rikako Asada ◽  
Satoshi Mizuno ◽  
Yoshihiko Yu ◽  
Yuji Hamamoto ◽  
...  
Keyword(s):  
Case Report ◽  
Epileptic Seizures ◽  
Drug Resistant ◽  
Corpus Callosotomy ◽  
Intact Male ◽  
Fluid Analysis ◽  
Postoperative Mri ◽  
Visual Analog Scales ◽  
Eeg Abnormalities ◽  
Drug Resistant Epilepsy

A 2-month-old, intact male domestic shorthair cat with dullness, bilateral central blindness, and recurrent epileptic seizures was presented to a local clinic. Seizures were the generalized myoclonic and tonic-clonic type. Phenobarbital was initiated and maintained; however, seizures were not controlled. Other anti-seizure drugs, including levetiracetam, zonisamide, and diazepam, also provided insufficient seizure control with seizures occurring hourly to daily. By 8 months of age, the cat displayed non-ambulatory tetraparesis and deep somnolence. Magnetic resonance imaging (MRI), cerebrospinal fluid analysis, and pre- and post-prandial total bile acid analyses were unremarkable. Scalp electroencephalography (EEG) revealed central dominant but generally synchronized spikes and multiple spikes. The cat was diagnosed with drug-resistant epilepsy of unknown cause and was included in a clinical trial of epilepsy surgery. Given the unremarkable MRI and bilateral synchronized EEG abnormalities, a corpus callosotomy was performed at 12 months of age, and partial desynchronization of spikes was confirmed on EEG. Incomplete transection was found in the genu of the corpus callosum on postoperative MRI. After surgery, the mental status and ambulation clearly improved, and seizure frequency and duration were remarkably reduced. Recheck with follow-up EEG and MRI were performed at 3, 6, and 12 months after surgery. Scores of activities of daily living and visual analog scales including cat's and owner's quality of life had also improved considerably. This case report is the first documentation of the one-year clinical outcome of corpus callosotomy in a clinical feline case with drug-resistant epilepsy.

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