Insufficient Efficacy of Corpus Callosotomy for Epileptic Spasms With Biphasic Muscular Contractions
Corpus callosotomy (CC) is the surgical strategy for drug-resistant epileptic seizures including epileptic spasms (ES). In this study we report a subtype of ES which is accompanied by two consecutive muscular contractions. This subtype has not been previously classified and may emerge via a complex...
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Frontiers Media S.A.
2020-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00232/full |
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| author | Sotaro Kanai Sotaro Kanai Tohru Okanishi Mitsuyo Nishimura Masayoshi Oguri Hideo Enoki Yoshihiro Maegaki Ayataka Fujimoto |
| author_facet | Sotaro Kanai Sotaro Kanai Tohru Okanishi Mitsuyo Nishimura Masayoshi Oguri Hideo Enoki Yoshihiro Maegaki Ayataka Fujimoto |
| author_sort | Sotaro Kanai |
| collection | DOAJ |
| description | Corpus callosotomy (CC) is the surgical strategy for drug-resistant epileptic seizures including epileptic spasms (ES). In this study we report a subtype of ES which is accompanied by two consecutive muscular contractions. This subtype has not been previously classified and may emerge via a complex epileptic network. We named these seizures “epileptic spasms with biphasic muscular contractions (ES-BMC)” and analyzed the association between them and CC outcomes. We enrolled 17 patients with ES who underwent CC before 20 years of age, and analyzed the records of long-term video-electroencephalogram (EEG) recordings. The outcomes of CC were ES-free (Engel's classification I) in 7 and residual ES (II to IV) in 10 patients. We statistically analyzed the associations between the presence of preoperative ES-BMC and the outcomes. Ages at CC ranged from 17 to 237 months. We analyzed 4–44 ictal EEGs for each patient. Five patients presented with ES-BMC with 6–40% of their whole ES on the presurgical video-EEG recordings, and all of them exhibited residual ES outcomes following CC. A Fisher's exact test revealed a significant positive correlation between the presence of preoperative ES-BMC and persistence of ES following CC (p = 0.044, odds ratio = 15.0, risk ratio = 2.0). The presence of ES-BMC may be useful in the presurgical prediction of CC outcomes in patients with ES. |
| first_indexed | 2024-04-12T11:54:30Z |
| format | Article |
| id | doaj.art-254aa7cc12f94949a7f28b1ea00b0018 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T11:54:30Z |
| publishDate | 2020-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-254aa7cc12f94949a7f28b1ea00b00182022-12-22T03:34:02ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-04-011110.3389/fneur.2020.00232493744Insufficient Efficacy of Corpus Callosotomy for Epileptic Spasms With Biphasic Muscular ContractionsSotaro Kanai0Sotaro Kanai1Tohru Okanishi2Mitsuyo Nishimura3Masayoshi Oguri4Hideo Enoki5Yoshihiro Maegaki6Ayataka Fujimoto7Division of Child Neurology, Faculty of Medicine, Institute of Neurological Sciences, Tottori University, Yonago, JapanDepartment of Child Neurology, Seirei-Hamamatsu General Hospital, Hamamatsu, JapanDepartment of Child Neurology, Seirei-Hamamatsu General Hospital, Hamamatsu, JapanLaboratory of Neurophysiology, Seirei-Hamamatsu General Hospital, Hamamatsu, JapanDivision of Pathobiological Science and Technology, Faculty of Medicine, School of Health Sciences, Tottori University, Yonago, JapanDepartment of Child Neurology, Seirei-Hamamatsu General Hospital, Hamamatsu, JapanDivision of Child Neurology, Faculty of Medicine, Institute of Neurological Sciences, Tottori University, Yonago, JapanComprehensive Epilepsy Center, Seirei-Hamamatsu General Hospital, Hamamatsu, JapanCorpus callosotomy (CC) is the surgical strategy for drug-resistant epileptic seizures including epileptic spasms (ES). In this study we report a subtype of ES which is accompanied by two consecutive muscular contractions. This subtype has not been previously classified and may emerge via a complex epileptic network. We named these seizures “epileptic spasms with biphasic muscular contractions (ES-BMC)” and analyzed the association between them and CC outcomes. We enrolled 17 patients with ES who underwent CC before 20 years of age, and analyzed the records of long-term video-electroencephalogram (EEG) recordings. The outcomes of CC were ES-free (Engel's classification I) in 7 and residual ES (II to IV) in 10 patients. We statistically analyzed the associations between the presence of preoperative ES-BMC and the outcomes. Ages at CC ranged from 17 to 237 months. We analyzed 4–44 ictal EEGs for each patient. Five patients presented with ES-BMC with 6–40% of their whole ES on the presurgical video-EEG recordings, and all of them exhibited residual ES outcomes following CC. A Fisher's exact test revealed a significant positive correlation between the presence of preoperative ES-BMC and persistence of ES following CC (p = 0.044, odds ratio = 15.0, risk ratio = 2.0). The presence of ES-BMC may be useful in the presurgical prediction of CC outcomes in patients with ES.https://www.frontiersin.org/article/10.3389/fneur.2020.00232/fullepileptic spasms with biphasic muscular contractionsepileptic spasmscorpus callosumcorpus callosotomyepilepsy surgery |
| spellingShingle | Sotaro Kanai Sotaro Kanai Tohru Okanishi Mitsuyo Nishimura Masayoshi Oguri Hideo Enoki Yoshihiro Maegaki Ayataka Fujimoto Insufficient Efficacy of Corpus Callosotomy for Epileptic Spasms With Biphasic Muscular Contractions Frontiers in Neurology epileptic spasms with biphasic muscular contractions epileptic spasms corpus callosum corpus callosotomy epilepsy surgery |
| title | Insufficient Efficacy of Corpus Callosotomy for Epileptic Spasms With Biphasic Muscular Contractions |
| title_full | Insufficient Efficacy of Corpus Callosotomy for Epileptic Spasms With Biphasic Muscular Contractions |
| title_fullStr | Insufficient Efficacy of Corpus Callosotomy for Epileptic Spasms With Biphasic Muscular Contractions |
| title_full_unstemmed | Insufficient Efficacy of Corpus Callosotomy for Epileptic Spasms With Biphasic Muscular Contractions |
| title_short | Insufficient Efficacy of Corpus Callosotomy for Epileptic Spasms With Biphasic Muscular Contractions |
| title_sort | insufficient efficacy of corpus callosotomy for epileptic spasms with biphasic muscular contractions |
| topic | epileptic spasms with biphasic muscular contractions epileptic spasms corpus callosum corpus callosotomy epilepsy surgery |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00232/full |
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