Uncovered primary seizure foci in Lennox-Gastaut syndrome after corpus callosotomy

Yun Jung Hur, Hoon Chul Kang, Dong Seok Kim, Sae Rom Choi, Heung Dong Kim, Joon Soo Lee

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose: Corpus callosotomy (CC) is a palliative surgical procedure to control atonic, tonic, or generalized tonic-clonic seizure in Lennox-Gastaut syndrome (LGS). Here, we report patients with LGS who underwent resective surgery, following CC better delineating the presumed seizure foci localized in one hemisphere. Methods: We retrospectively reviewed seven patients with LGS who underwent CC and subsequent cortical resection. The median follow-up duration after lobectomy was 20. months (range, 15-54. months) and three patients had follow-up periods over 24. months. The findings of video electroencephalography (EEG) monitoring, structural and functional neuroimagings were compared between pre- and post-CC. Results: Four patients had Engel class I and one patient had Engel class II outcomes following cortical resection; post-CC, compared to pre-CC, showed better localized ictal/interictal epileptiform discharges in the unilateral frontal area in two patients, in the unilateral parieto-temporo-occipital areas in one patient and in the unilateral fronto-temporal areas in the remaining two patients. Two patients had Engel Class III outcome following cortical resection; post-CC EEG continued to show multifocal epileptiform discharges but predominantly arising from a unilateral frontal area. Following CC, positron emission tomography showed localized glucose hypometabolism of which location was concordant with post-CC EEG abnormalities in all patient. Similarly, ictal/interictal single photon emission computed tomography also showed localized abnormalities concordant with post-CC EEG abnormalities in five of the six patients. Pathological assessment revealed cortical dysplasia in six patients, whereas no pathological abnormality was found in the remaining patient, who obtained Engel Class I outcome following cortical resection. Conclusion: CC could change EEG findings, glucose metabolisms and cerebral blood flows, and it is sometimes helpful in delineating the primary seizure focus in patients with LGS.

Original languageEnglish
Pages (from-to)672-677
Number of pages6
JournalBrain and Development
Volume33
Issue number8
DOIs
Publication statusPublished - 2011 Sep 1

Fingerprint

Seizures
Electroencephalography
Lennox Gastaut Syndrome
Cerebrovascular Circulation
Stroke
Malformations of Cortical Development
Glucose
Functional Neuroimaging
Single-Photon Emission-Computed Tomography
Positron-Emission Tomography

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Clinical Neurology

Cite this

Hur, Yun Jung ; Kang, Hoon Chul ; Kim, Dong Seok ; Choi, Sae Rom ; Kim, Heung Dong ; Lee, Joon Soo. / Uncovered primary seizure foci in Lennox-Gastaut syndrome after corpus callosotomy. In: Brain and Development. 2011 ; Vol. 33, No. 8. pp. 672-677.
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Uncovered primary seizure foci in Lennox-Gastaut syndrome after corpus callosotomy. / Hur, Yun Jung; Kang, Hoon Chul; Kim, Dong Seok; Choi, Sae Rom; Kim, Heung Dong; Lee, Joon Soo.

In: Brain and Development, Vol. 33, No. 8, 01.09.2011, p. 672-677.

Research output: Contribution to journalArticle

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