Callosotomy: should it be indicated earlier?

نویسندگان

چکیده

Case presentation: Male 9 years and months old patient with cerebral palsy (GMFCS5) refractory epilepsy secondary to extensive bilateral hypoxic ischemic encephalopathy started epileptic seizures in the first hours of life after evolved persistent countless daily polymorphic seizures. He was diagnosed West syndrome (WS) followed by Lennox-Gastaut (LGS). got many treatments, a total more than 10 anti-crisis drugs (ACD), including rufinamide, explored single or polytherapy maximum tolerated doses. also underwent alternative treatments acetazolamide, corticosteroids, cannabidiol, ketogenic diet. No therapeutic measure showed efficacy above 50%. At old, he evaluated neurosurgery team video electroencephalography (EEG) an increase interhemispheric synchronization spindle-like segments rapid rhythmic activity record tonic-type spasms cluster. A callosotomy performed 4 later. Two surgery, patient's mother reported 80% reduction number attacks decrease their duration. In last EEG, no burst-suppression pattern detected as EEG before surgery. There persistence multifocal epileptiform activity, left occipital right frontocentral predominance.

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ژورنال

عنوان ژورنال: Arquivos De Neuro-psiquiatria

سال: 2023

ISSN: ['1678-4227', '0004-282X']

DOI: https://doi.org/10.1055/s-0043-1774638