Corpus Callosotomy for Controlling Epileptic Spasms: A Proposal for Surgical Selection

In 1940, van Wagenen and Herren first proposed the corpus callosotomy (CC) as a surgical procedure for epilepsy. CC has been mainly used to treat drop attacks, which are classified as generalized tonic or atonic seizures. Epileptic spasms (ESs) are a type of epileptic seizure characterized as brief muscle contractions with ictal polyphasic slow waves on an electroencephalogram and a main feature of West syndrome. Resection surgeries, including frontal/posterior disconnections and hemispherotomy, have been established for the treatment of medically intractable ES in patients with unilaterally localized epileptogenic regions. However, CC has also been adopted for ES treatment, with studies involving CC to treat ES having increased since 2010. In those studies, patients without lesions observed on magnetic resonance imaging or equally bilateral lesions predominated, in contrast to studies on resection surgeries. Here, we present a review of relevant literature concerning CC and relevant adaptations. We discuss history and adaptations of CC, and patient selection for epilepsy surgeries due to medically intractable ES, and compared resection surgeries with CC. We propose a surgical selection flow involving resection surgery or CC as first-line treatment for patients with ES who have been assessed as suitable candidates for surgery.

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Cost-effectiveness of Molecular Profile Patient Selection for First-line Treatment of Recurrent/Metastatic Head and Neck Cancer

Clinical Therapeutics ◽

10.1016/j.clinthera.2019.09.015 ◽

2019 ◽

Vol 41 (12) ◽

pp. 2517-2528.e28 ◽

Cited By ~ 1

Author(s):

Carla Rognoni ◽

Silvana Quaglini ◽

Jan Baptist Vermorken ◽

Loris De Cecco ◽

Lisa Licitra ◽

...

Keyword(s):

Head And Neck Cancer ◽

Cost Effectiveness ◽

Head And Neck ◽

Neck Cancer ◽

Patient Selection ◽

Molecular Profile ◽

Line Treatment ◽

First Line ◽

Selection For ◽

First Line Treatment

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Vigabatrin for Epileptic Spasms and Tonic Seizures in Tuberous Sclerosis Complex

Journal of Child Neurology ◽

10.1177/0883073818768309 ◽

2018 ◽

Vol 33 (8) ◽

pp. 519-524 ◽

Cited By ~ 8

Author(s):

Emma A. van der Poest Clement ◽

Mustafa Sahin ◽

Jurriaan M. Peters

Keyword(s):

Tuberous Sclerosis ◽

Tuberous Sclerosis Complex ◽

Retinal Toxicity ◽

Infantile Spasms ◽

Line Treatment ◽

First Line ◽

Epileptic Spasms ◽

Treatment Onset ◽

First Line Treatment

Vigabatrin is recommended as first-line treatment for infantile spasms in tuberous sclerosis complex (TSC), but other indications in children with tuberous sclerosis complex are less known. We retrospectively reviewed 201 children with tuberous sclerosis complex, and identified 21 children older than 1 year started on vigabatrin for any indication and with sufficient follow-up data. The indication for vigabatrin was epileptic spasms (n = 13), tonic seizures (n = 5), both (n = 2), and status epilepticus (n = 1). Mean age of treatment onset was 4.0 years (range 1.1-18.3). All but 1 patient had a reduction in seizures. Ten patients became seizure free and 4 had an improvement of >90%. In 9 patients, vigabatrin was tapered successfully after 8 to 33 months. Side effects reported included rash (n = 1) and behavioral decline (n = 1). No retinal toxicity was detected in 14 of 21 patients with adequate ophthalmologic surveillance data. In conclusion, vigabatrin may be an effective treatment for epileptic spasms and tonic seizures beyond the infantile age.

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Parry Romberg disease with En Coup de Sabre Scleroderma: Effect of tocilizumab on periodontal bone inflammation

Journal of Scleroderma and Related Disorders ◽

10.1177/2397198320975872 ◽

2020 ◽

pp. 239719832097587

Author(s):

Thaís Cugler Meneghetti ◽

Juliana Yassue Barbosa da Silva ◽

Lúcio Eduardo Kluppel ◽

Vânia Oliveira de Carvalho

Keyword(s):

Pediatric Rheumatology ◽

Root Resorption ◽

Neurological Impairment ◽

Resonance Imaging ◽

First Line ◽

Pediatric Dermatology ◽

Systemic Immunosuppression ◽

The Face ◽

Bone Inflammation ◽

First Line Treatment

Parry Romberg disease and En Coupe de Sabre Scleroderma are frequently associated disorders that affect the face and can cause severe aesthetic and functional impairment. Systemic immunosuppression is the gold standard of first-line treatment in the pediatric rheumatology standpoint although it is often delayed in the pediatric dermatology clinics and more often used in cases of refractory neurological impairment. We report on a case with dental root resorption and severe periodontal bone inflammation detected on magnetic resonance imaging, which was successfully treated with the anti-IL-6 agent tocilizumab.

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Corpus callosotomy versus vagus nerve stimulation for atonic seizures and drop attacks: A systematic review

Epilepsy & Behavior ◽

10.1016/j.yebeh.2015.06.001 ◽

2015 ◽

Vol 51 ◽

pp. 13-17 ◽

Cited By ~ 25

Author(s):

John D. Rolston ◽

Dario J. Englot ◽

Doris D. Wang ◽

Paul A. Garcia ◽

Edward F. Chang

Keyword(s):

Systematic Review ◽

Vagus Nerve ◽

Nerve Stimulation ◽

Vagus Nerve Stimulation ◽

Corpus Callosotomy ◽

Drop Attacks ◽

Atonic Seizures

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The hormonal suppression as first-line treatment of lingual thyroid: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x211050470 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110504

Author(s):

Snežana Knežević ◽

Anđelka Dugalić ◽

Branimir Dugalić

Keyword(s):

Thyroid Gland ◽

Thyroid Tissue ◽

Lingual Thyroid ◽

Line Treatment ◽

Resonance Imaging ◽

First Line ◽

Normal Thyroid Tissue ◽

Tumour Infiltration ◽

Base Of The Tongue ◽

First Line Treatment

Ectopic thyroid gland is a rare anomaly in the development of the thyroid gland. It is defined as any thyroid tissue that is not found on its usual topography. We present the case of a 62-year-old patient with difficulty swallowing solid food, occasional sore throat, hoarse voice, and difficulty speaking. The patient was in hypothyroid status. Thyroid scintigraphy and magnetic resonance imaging visualized a nodular mass on the base of the tongue, suprahyoid, and mediosagittal. The pathohistological finding revealed normal thyroid tissue with few colloidal changes, ruled out tumour infiltration and specific inflammatory process. She received hormonal suppression treatment as a first-line treatment. The patient showed significant improvement in symptoms with reduction of the dyspnea and the dysphagia and normalization of thyroid hormone tests.

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