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Anterior corpus callosotomy: effects in a patient with congenital bilateral perisylvian syndrome and oromotor seizures

  • Ambrosetto G. 
  • Antonini L. 
Case Reports

Abstract

Anterior corpus callosotomy was performed in a patient with pseudobulbar palsy, mild mental retardation and intractable epilepsy related to congenital bilateral perisylvian cortical dysplasia. Before surgery, she had daily atonic drop attacks, rare and mainly sleep-related oromotor seizures, and multifocal and diffuse paroxysmal EEG discharges; after callosotomy, less abrupt atonic drop attacks recurred monthly and the EEG epileptiform abnormalities disappeared. Video-EEG sleep recordings revealed the clinically unsuspected serial recurrence of oromotor seizures, probably related to the clinically observed aggravation of dysarthria. New surgical techniques, in addition or alternative to callosotomy, should be developed in order to avoid or reduce the risk of aggravating some types of partial seizures in patients with bilateral cortical displastic lesions, intractable epilepsy and epileptic falls.

Key Words

callosotomy epileptic drops oromotor seizures congenital bilateral perisylvian syndrome 

Sommario

Una callosotomia anteriore fu effettuata in una paziente con paralisi pseudobulbare, ritardo mentale di medio grado ed epilessia intrattabile correlati a displasia perisilviana bilaterale congenita. Prima dell'intervento la paziente presentava drops epilettici giornalieri, rare crisi oromotorie soprattutto durante il sonno e anomalie EEG parossistiche multifocali e diffuse. Dopo la callosotomia i drops epilettici divennero meno brutali e a ricorrenza mensile mentre le anomalie EEG scomparvero. Alcune registrazioni video-EEG durante il sonno rivelarono una ricorrenza seriata di crisi oromotorie, non sospettabile clinicamente, probabilmente correlata all'aggravamento della disartria notata dopo l'intervento chirurgico. È giustificabile l'introduzione di nuove tecniche chirurgiche aggiuntive o sostitutive della callosotomia nei pazienti con lesioni corticali displastiche bilaterali, epilessia intrattabile e cadute epilettiche, al fine di eliminare o ridurre il rischio di aggravamento di alcuni tipi di crisi focali.

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Copyright information

© Masson Italia Periodici S.r.l. 1995

Authors and Affiliations

  • Ambrosetto G. 
    • 1
  • Antonini L. 
    • 2
  1. 1.Istituto di Clinica NeurologicaUniversità di BolognaBolognaItaly
  2. 2.Servizio di NeurofisiologiaOspedale CivileBrescia

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