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- Title
Endoscopic Total Corpus Callosotomy and Pan Commissurotomy for Lennox–Gastaut Syndrome.
- Authors
Doddamani, Ramesh; Kota, Ravi; Ahemad, Nihal; Chandra, Sarat; Tripathi, Manjari
- Abstract
Background: Corpus callosotomy (CC) is a major disconnection procedure that functionally isolates the cerebral hemispheres, thereby interrupting the spread of epileptic activity from one hemisphere to the other. It is extremely useful in children suffering from non-localized drug refractory epilepsy, especially drop attacks. The technique has evolved from microscopic to minimally invasive endoscopic surgery. The extent of callosotomy also varies based on the institutional practices ranging from anterior 1/3rd to total corpus callosotomies (TCC). The performance of TCC in conjunction with anterior, posterior, and hippocampal commissurotomies was described for the first time by the senior author from our institution. Objective: To describe the technique of performing endoscopic total corpus callosotomy, and pan commissurotomy using the interhemispheric corridor. Methods: A 12-year-old girl with seizure onset at the age of 10 years presented with aura of fear and nausea followed by tonic deviation of eyes to the right, and blinking with speech arrest. There were tonic-clonic movements of the right-side limbs along with ictal spitting, and occasional deviation of the angle of mouth to the right. Patient had loss of awareness for the event along with postictal confusion that lasted a few minutes. Results: Video electroencephalography (VEEG) revealed left parieto-central and left temporal localization. Serial MRI brain over three years revealed progressive left hemispheric changes suggestive of Rasmussen's encephalitis. Patient underwent left-sided endoscopic hemispherotomy. At two-year follow up, the patient was seizure-free (ILAE Class 1). Conclusion: Endoscopic corpus callosotomy and pan commissurotomy using the interhemispheric corridor is an elegant and minimally invasive technique best suited for appropriately selected children with refractory epilepsy.
- Publication
Neurology India, 2022, Vol 70, Issue 1, p63
- ISSN
0028-3886
- Publication type
Article
- DOI
10.4103/0028-3886.338654