title: Stepwise synchronization through the corpus callosum is one cause of myoclonic jerks.
abstract: BACKGROUND
  Epileptic myoclonus is generally treated by valproate monotherapy, and this therapy has confirmed efficacy. However, almost 30% of patients with juvenile myoclonic epilepsy (JME) are valproate-resistant.
  
  
  METHODS
  A 23-year-old man with a diagnosis of JME had resistance to multiple antiepileptic drugs (AEDs). Stepwise synchronization of bilateral spikes on electroencephalography (EEG) was found shortly before the clinical myoclonus. The anterior two thirds of the corpus callosum were divided. Desynchronization of spikes by the corpus callosotomy arrested the patient's myoclonus.
  
  
  CONCLUSIONS
  Interhemispheric recruitment of epileptic spikes through the corpus callosum may induce synchronization of spikes and myoclonus.
authors: Department of Neurosurgery, Juntendo University, Tokyo, Japan. debo@juntendo.ac.jp
authors: Yasushi
authors: Y
authors: Iimura
authors: Hidenori
authors: H
authors: Sugano
authors: Madoka
authors: M
authors: Nakajima
authors: Hajime
authors: H
authors: Arai
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology; D003337:Corpus Callosum / Q000503:physiopathology* / Q000601:surgery; D003344:Cortical Synchronization / Q000502:physiology*; D004351:Drug Resistance; D004569:Electroencephalography; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D009207:Myoclonus / Q000209:etiology* / Q000503:physiopathology* / Q000601:surgery; D019635:Neurosurgical Procedures; D012640:Seizures / Q000503:physiopathology; D013575:Syncope / Q000209:etiology; D014635:Valproic Acid / Q000627:therapeutic use; D055815:Young Adult; D000078305:Zonisamide
chemical_list: D000927:Anticonvulsants; D007555:Isoxazoles; D000078305:Zonisamide; D014635:Valproic Acid