title: Total corpus callosotomy for epileptic spasms after acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) in a case with tuberous sclerosis complex.
abstract: Corpus callosotomy is a palliative therapy for refractory epilepsy, including West syndrome, without a resectable epileptic focus. The surgical outcome of corpus callosotomy is relatively favorable in cryptogenic (non-lesional) West syndrome. Tuberous sclerosis complex (TSC) is a disorder that frequently leads to the development of refractory seizures by multiple cortical tubers. The multiple cortical tubers cause multiple or wide epileptic networks in these cases. Most of West syndrome cases in TSC with multiple tubers need additional resective surgery after corpus callosotomy. We describe a case of TSC in a boy aged 4years and 8months. He had multiple cortical tubers on his brain and developed epileptic spasms. The seizures were controlled with valproate. At the age of 1year and 4months, he presented with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD), and had relapsed epileptic spasms one month after the onset of the encephalopathy. The seizures were refractory to multiple antiepileptic drugs. A total corpus callosotomy was performed at the age of 3years and 8months. The patient did not show any seizures after the surgery. During 12months of the follow-up, the patient was free from any seizures. Even in cases of symptomatic WS with multiple lesions, total corpus callosotomy may be a good strategy if the patients have secondary diffuse brain insults.
authors.affiliation: Department of Child Neurology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 430-8558, Japan. Electronic address: okanishipediatrics@gmail.com.
authors.forename: Tohru
authors.initials: T
authors.lastname: Okanishi
authors.affiliation: Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 430-8558, Japan.
authors.forename: Ayataka
authors.initials: A
authors.lastname: Fujimoto
authors.affiliation: Department of Child Neurology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 430-8558, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Motoi
authors.affiliation: Department of Child Neurology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 430-8558, Japan.
authors.forename: Sotaro
authors.initials: S
authors.lastname: Kanai
authors.affiliation: Department of Neurophysiology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 430-8558, Japan.
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Nishimura
authors.affiliation: Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 430-8558, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yamazoe
authors.affiliation: Department of Pediatrics, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takagi
authors.affiliation: Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 430-8558, Japan.
authors.forename: Takamichi
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Child Neurology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 430-8558, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Enoki
mesh_terms: D002675:Child, Preschool; D003337:Corpus Callosum / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging; D004569:Electroencephalography; D004827:Epilepsy / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D014402:Tuberous Sclerosis / Q000150:complications* / Q000000981:diagnostic imaging
keywords: Acute encephalopathy with biphasic seizures and late reduced diffusion; Corpus callosotomy; Epileptic spasms; Tuberous sclerosis complex; West syndrome