Posterior disconnection in early infancy to treat intractable epilepsy with multilobar cortical dysplasia: three case report.
Extensive multilobar cortical dysplasias occasionally occur in children and can induce seizure onset in early infancy, causing severe epileptic encephalopathy. Surgical interventions in early infancy, such as disconnection of large parts of the brain, are challenging because of the degree of invasiveness and carry greater risks in infants compared with older children. Here we report the successful treatment of intractable epilepsy with multilobar cortical dysplasias in the posterior cortex by posterior disconnection in three infants (age 3 months). The patients showed good postoperative recovery and exhibited excellent seizure control at follow-up evaluation within a year after surgery. Developmental catch-up was also achieved and no early complications have been detected to date. Use of the posterior disconnection technique for early-stage extensive multilobar cortical dysplasias can result in good seizure control and developmental progress with little perioperative morbidity. However, the efficacy of this surgical technique needs to be verified with long-term follow up after surgery.
Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xian, China.
Qin-Chuan
QC
Liang
Taisuke
T
Otsuki
Akio
A
Takahashi
Takashi
T
Enokizono
Takanobu
T
Kaido
Yuu
Y
Kaneko
Eiji
E
Nakagawa
Kenji
K
Sugai
Masayuki
M
Sasaki
D038481:Anterior Temporal Lobectomy / Q000379:methods*; D002540:Cerebral Cortex / Q000473:pathology; D004569:Electroencephalography; D004830:Epilepsy, Tonic-Clonic / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D054220:Malformations of Cortical Development / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D012086:Reoperation; D013036:Spasms, Infantile / Q000175:diagnosis / Q000601:surgery*; D013382:Subtraction Technique; D015899:Tomography, Emission-Computed, Single-Photon