title: Corpus callosotomy in a patient with startle epilepsy.
abstract: Startle epilepsy is a syndrome of reflex epilepsy in which the seizures are precipitated by a sudden and surprising, usually auditory, stimulus. We describe herein a girl who had been suffering with startle-induced seizures since 2 years of age. She had focal, tonic and tonic-clonic seizures, refractory to antiepileptic treatment. Daily tonic seizures led to very frequent falls and morbidity. Neurologically, she had no deficit. Interictal EEG showed slow waves and epileptiform discharges in central and fronto-central regions. Video-polygraphic recordings of seizures, triggered by stimuli, showed generalised symmetric tonic posturing with ictal EEG, characterised by an abrupt and diffuse electrodecremental pattern of fast activity, followed by alpha-theta rhythm superimposed by epileptic discharges predominantly over the vertex and anterior regions. Magnetic resonance imaging showed no abnormalities. Corpus callosotomy was performed when the patient was 17. Since surgery, the patient (one year follow-up) has remained seizure-free. Corpus callosotomy may be considered in patients with startle epilepsy and tonic seizures, in the absence of focal lesions amenable to surgery. [Published with video sequences].
authors.affiliation: Neuropediatric Department, Cuban Institute of Neurology and Neurosurgery, Havana, Cuba. nicogaro72@gmail.com
authors.forename: Nicolás Garófalo
authors.initials: NG
authors.lastname: Gómez
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Hamad
authors.forename: Murilo
authors.initials: M
authors.lastname: Marinho
authors.forename: Igor M
authors.initials: IM
authors.lastname: Tavares
authors.forename: Henrique
authors.initials: H
authors.lastname: Carrete
authors.forename: Luís Otávio
authors.initials: LO
authors.lastname: Caboclo
authors.forename: Elza Márcia
authors.initials: EM
authors.lastname: Yacubian
authors.forename: Ricardo
authors.initials: R
authors.lastname: Centeno
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D003337:Corpus Callosum / Q000601:surgery*; D020195:Epilepsy, Reflex / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: callosotomy; reflex seizure; startle epilepsy