Analysis for the Association Between Corpus Callosum Thickness and Corpus Callosotomy Outcomes for Patients With Epileptic Spasms or Tonic Spasms

Itamura, Shinji; Okanishi, Tohru; Nishimura, Mitsuyo; Kanai, Sotaro; Baba, Shimpei; Masuda, Yasushi; Homma, Yoichiro; Enoki, Hideo; Fujimoto, Ayataka

doi:10.1016/j.pediatrneurol.2019.01.012

Cited by 10 publications

(13 citation statements)

References 18 publications

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“…Some previous studies have demonstrated the efficacy of CC for alleviating ES 11–13 . Pinard et al .…”

Section: Discussionmentioning

confidence: 99%

“…The pathophysiologic basis of CC is the hypothesis that the corpus callosum is the most important pathway for the spread of epileptic activity between the two hemispheres of the brain 10 . Some reports have indicated that CC exerts beneficial effects in patients with ES 11–13 . In these studies, ES were eliminated after CC in 42 of 87 patients.…”

Section: Introductionmentioning

confidence: 99%

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Symmetry of ictal slow waves may predict the outcomes of corpus callosotomy for epileptic spasms

Kanai

Oguri

Okanishi

et al. 2019

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We aimed to analyse the ictal electrographic changes on scalp electroencephalography (EEG), focusing on high-voltage slow waves (HVSs) in children with epileptic spasms (ES) and tonic spasms (TS) and then identified factors associated with corpus callosotomy (CC) outcomes. We enrolled 17 patients with ES/TS who underwent CC before 20 years of age. Post-CC Engel’s classification was as follows: I in 7 patients, II in 2, III in 4, and IV in 4. Welch’s t-test was used to analyse the correlation between ictal HVSs and CC outcomes based on the following three symmetrical indices: (1) negative peak delay: interhemispheric delay between negative peaks; (2) amplitude ratio: interhemispheric ratio of amplitude values for the highest positive peaks; and (3) duration ratio: interhemispheric ratio of slow wave duration. Ages at CC ranged from 17–237 months. Four to 15 ictal EEGs were analysed for each patient. The negative peak delay, amplitude ratio and duration ratio ranged from 0–530 ms, 1.00–7.40 and 1.00–2.74, respectively. The negative peak delay, amplitude ratio and duration ratio were significantly higher in the seizure residual group (p = 0.017, <0.001, <0.001, respectively). Symmetry of ictal HVSs may predict favourable outcomes following CC for ES/TS.

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“…Some previous studies have demonstrated the efficacy of CC for alleviating ES 11–13 . Pinard et al .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Symmetry of ictal slow waves may predict the outcomes of corpus callosotomy for epileptic spasms

Kanai

Oguri

Okanishi

et al. 2019

Sci Rep

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“…We performed scalp video-EEG in 12 patients following CC. We used a NicoletOne system for patients 3, 12, 13, 15, and 16, and a Neurofax system for patients 1,5,8,9,10,14, and 17. The sampling rate was set at 256 Hz (patients 3, 12, and 15), 400 Hz (patients 3, 12, 13, and 15), 500 Hz (patients 1, 5, 8, 9, 10, 14, and 17), or 512 Hz (patient 16).…”

Section: Postoperative Scalp Video-eeg Recordingsmentioning

confidence: 99%

“…Previous studies have indicated that CC exerts a beneficial effect on approximately half of patients with ES (7)(8)(9). The disconnection of the corticocortical pathway via the corpus callosum is thought to eliminate the interhemispheric mutual irritating of ES.…”

Section: Symmetry Of Es and The Corpus Callosummentioning

confidence: 99%

“…The pathophysiologic basis of CC is based on the hypothesis that the corpus callosum is the most important pathway for the spread of epileptic activity between the two hemispheres (6). Some reports have indicated that CC has beneficial effects in patients with ES (7)(8)(9). In these studies, ES were eliminated following CC in 42 of 87 patients.…”

Section: Introductionmentioning

confidence: 99%

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Insufficient Efficacy of Corpus Callosotomy for Epileptic Spasms With Biphasic Muscular Contractions

et al. 2020

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Corpus callosotomy (CC) is the surgical strategy for drug-resistant epileptic seizures including epileptic spasms (ES). In this study we report a subtype of ES which is accompanied by two consecutive muscular contractions. This subtype has not been previously classified and may emerge via a complex epileptic network. We named these seizures "epileptic spasms with biphasic muscular contractions (ES-BMC)" and analyzed the association between them and CC outcomes. We enrolled 17 patients with ES who underwent CC before 20 years of age, and analyzed the records of long-term videoelectroencephalogram (EEG) recordings. The outcomes of CC were ES-free (Engel's classification I) in 7 and residual ES (II to IV) in 10 patients. We statistically analyzed the associations between the presence of preoperative ES-BMC and the outcomes. Ages at CC ranged from 17 to 237 months. We analyzed 4-44 ictal EEGs for each patient. Five patients presented with ES-BMC with 6-40% of their whole ES on the presurgical video-EEG recordings, and all of them exhibited residual ES outcomes following CC. A Fisher's exact test revealed a significant positive correlation between the presence of preoperative ES-BMC and persistence of ES following CC (p = 0.044, odds ratio = 15.0, risk ratio = 2.0). The presence of ES-BMC may be useful in the presurgical prediction of CC outcomes in patients with ES.

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Kallosotomien bei Sturzanfällen und epileptischen Spasmen

et al. 2021

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ZusammenfassungDie Kallosotomie ist eine palliative Operation, die seit fast 80 Jahren bei Patienten mit therapierefraktären, bilateralen Anfällen eingesetzt wird, wenn ein resektives Verfahren nicht möglich ist. Neuere, minimal-invasive Techniken wie die MRT-gesteuerte laserinduzierte Thermokoagulation sind vermutlich vergleichbar bezüglich Outcome und Komplikationsraten, die Datenlage ist aber insgesamt noch spärlich. In vielen Fallserien war die Kallosotomie v. a. in der Reduktion von Sturzanfällen effektiv, in geringerem Ausmaß auch für epileptische Spasmen. Eine vollständige Anfallsfreiheit wird nur sehr selten erreicht. Chirurgische Komplikationen wie Blutungen oder Infektionen treten in etwa 5 % auf. Die wichtigste, jedoch sehr seltene Nebenwirkung der Kallosotomie ist ein Diskonnektionssyndrom mit Apraxie, taktiler und visueller Anomie, Neglect oder SMA(supplementär-motorisches Areal)-Syndrom. Besonders bei Kindern ist das Diskonnektionssyndrom in aller Regel transient. Ob eine anteriore oder eine komplette Kallosotomie durchgeführt wird, variiert von Zentrum zu Zentrum. Komplette Kallosotomien sind hinsichtlich der Anfallsreduktion effizienter, gehen aber mit einem höheren Risiko für Komplikationen und Nebenwirkungen einher. Eine Option ist eine zweistufige Kallosotomie, bei der zunächst eine anteriore Diskonnektion durchgeführt wird und in den Fällen ohne hinreichenden postoperativen Nutzen in einem zweiten Schritt vervollständigt wird.

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Analysis for the Association Between Corpus Callosum Thickness and Corpus Callosotomy Outcomes for Patients With Epileptic Spasms or Tonic Spasms

Cited by 10 publications

References 18 publications

Symmetry of ictal slow waves may predict the outcomes of corpus callosotomy for epileptic spasms

Symmetry of ictal slow waves may predict the outcomes of corpus callosotomy for epileptic spasms

Insufficient Efficacy of Corpus Callosotomy for Epileptic Spasms With Biphasic Muscular Contractions

Kallosotomien bei Sturzanfällen und epileptischen Spasmen

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