title: Steal phenomenon in Sturge-Weber syndrome imitating an ictal electroencephalography change in the contralateral hemisphere: report of 2 cases.
abstract: Infants with Sturge-Weber syndrome (SWS) are considered for surgery if they develop seizures and the seizures prove medically refractory. The authors report on 2 infants (15 and 19 months old) with SWS who underwent scalp video electroencephalography (EEG) and subsequent functional hemispherotomy for intractable partial motor seizures due to extensive left hemispheric angiomatosis. They presented with similar interictal and ictal EEG findings. Ictal EEG showed abrupt high-amplitude delta slow waves, without evolution on the contralateral hemisphere before the build-up of ictal EEG changes on the lesional hemisphere. The patients became seizure free after hemispherotomy. The ictal contralateral slow waves were not a sign of an ictal hemisphere and may indicate prominent ischemic changes resulting from a steal phenomenon of hemispheric angiomatosis during seizure.
authors.affiliation: Divisions of 1 Neurology and.
authors.forename: Chusak
authors.initials: C
authors.lastname: Limotai
authors.affiliation: Divisions of 1 Neurology and.
authors.forename: Cristina Y
authors.initials: CY
authors.lastname: Go
authors.affiliation: Divisions of 1 Neurology and.
authors.forename: Shiro
authors.initials: S
authors.lastname: Baba
authors.affiliation: Divisions of 1 Neurology and.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Okanari
authors.affiliation: Divisions of 1 Neurology and.
authors.forename: Ayako
authors.initials: A
authors.lastname: Ochi
authors.affiliation: Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: James T
authors.initials: JT
authors.lastname: Rutka
authors.forename: O Carter
authors.initials: OC
authors.lastname: Snead
authors.affiliation: Divisions of 1 Neurology and.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Otsubo
mesh_terms: D000798:Angiomatosis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D002545:Brain Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D002493:Central Nervous System Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D054022:Cerebrum / Q000601:surgery; D004569:Electroencephalography; D005260:Female; D038421:Hemispherectomy; D006801:Humans; D007223:Infant; D008297:Male; D012640:Seizures / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D013341:Sturge-Weber Syndrome / Q000150:complications*
keywords: AP = anteroposterior; CBF = cerebral blood flow; EEG = electroencephalography; HFF = high-frequency filter; LFF = low-frequency filter; SWS = Sturge-Weber syndrome; VEEG = video EEG; blood flow; hemispherotomy; ictal contralateral slow waves; infant; oncology; seizure