Post-section recruitment of epileptiform discharges in electrocorticography during callosotomy in 48 patients with Lennox-Gastaut syndrome.

We aimed to clarify the relationships between post-sectional recruitment of epileptiform discharges (PRED) seen in electrocorticograms (ECoG) during callosotomy in patients with Lennox-Gastaut syndrome (LGS) and postoperative seizure outcome. We retrospectively analyzed ECoG obtained during subtotal callosotomy (6 cm) in 48 patients with LGS (32 males, 16 females; age range, 1-20 years; mean age, 7.6 years) from July 1993 to November 1996 and compared recorded findings with postoperative seizure outcome.

Polymorphisms of DNA repair pathway genes and cigarette smoking in relation to susceptibility to large artery atherosclerotic stroke among ethnic Chinese in Taiwan.

Aim: Cigarette-smoking induced oxidative DNA damage to endothelial cells has been reported to play an etiological role in atherosclerosis development. Individual vulnerability to oxidative stress through smoking exposure and the ability to repair DNA damage, which plays a critical role in modifying the risk susceptibility of large artery atherosclerotic (LAA) stroke, is hypothesized. Thus, we examined the effect of genetic polymorphisms of DNA repair pathway genes and cigarette smoking in relation to risk susceptibility of LAA stroke.

An atypical case of Lennox-Gastaut syndrome not associated with mental retardation: a nosological issue.

The characteristic electroclinical features of Lennox-Gastaut syndrome (LGS) have been extensively reported, but the influence of the constellation of slow spike-and-wave (SSW) complexes with multiple seizure types (including atypical absence seizures [AAS] and tonic seizures [TS]) on patients with this syndrome is still unclear. We report the case of a 28-year-old woman who developed AAS and brief asymmetric TS at the age of 14 years. Her seizure disorder met diagnostic criteria for LGS (SSW on electroencephalogram and multiple seizure types), but there was no intellectual impairment and an interictal alpha EEG.

Reflex absence epilepsy induced by gait.

Reflex epilepsy is characterized by seizures that are precipitated by a specific identifiable factor. We describe here the case of a 21-year-old man with notable absence epilepsy since the age of 11 who experienced generalized convulsions 2 years after onset (in the absence of antiepileptic therapy) and reflex absence seizures triggered by walking 7-10 steps. To our knowledge, this case report is the first describing reflex absence epilepsy seizures induced by gait.

Electrocorticogram changes during corpus callosotomy for uncontrolled symptomatic generalized epilepsy.

We report a 19-year-old man who presented to our facility with medically intractable, symptomatic generalized epilepsy manifesting as generalized tonic-clonic seizures (GTCs). Before he underwent an anterior callosotomy (6 cm), these seizures, which he had experienced for 11 years, seemed to have a left-sided focal origin. Intraoperatively, no epileptiform discharges were found on the electrocorticogram (ECoG) performed prior to sectioning, but more than 10 left-sided seizures were recorded after sectioning.

Corpus callosotomy in a patient of hemimegalencephaly and Lennox-Gastaut syndrome.

We report the case of a girl with hemimegalencephaly (HME) and Lennox-Gastaut syndrome (LGS) treated by callosotomy at 1 year of age. Over 10 years, her seizure frequency and severity decreased markedly. Hemispherectomy is the main surgical option for HME although HME appears to correlate with a less favorable seizure outcome.

Mixed alien hand syndrome coexisting with left-sided extinction secondary to a left corpus callosal lesion: a case report.

Alien hand syndrome (AHS) is actually two distinct syndromes with distinct clinical and anatomic features, that is, a frontal type and a callosal type. Frontal AHS occurs in the dominant hand; is associated with reflexive grasping, groping, and compulsive manipulation of tools. Callosal AHS is characterized primarily by intermanual conflict.

Postictal aphasia with transient sulcal hyperintensity on MRI.

A 38-year-old man had postictal global aphasia after generalized tonic-clonic seizure, but recovered within 1 day. There was a focal increase in the signal intensity of the left frontoparietal sulci on fluid-attenuated inversion recovery magnetic resonance (MR) sequence 6 hours after the seizure, which disappeared 1 month later. The transient seizure-induced MR hyperintensity was possibly caused by ictal or postictal hyperemia and breakdown of the blood-brain barrier.

A comparison of seizure outcome after callosotomy in patients with Lennox-Gastaut syndrome and a positive or negative history for West syndrome.

Purpose: This retrospective study was designed to clarify the role of West syndrome in post-callosotomy seizure outcome in patients with Lennox-Gastaut syndrome.

Methods: From September 1989 to May 1999, 74 patients diagnosed with Lennox-Gastaut syndrome received anterior corpus callosotomy at Taipei Veterans General Hospital, Taiwan. All patients were followed for more than 4 years after surgery.

Cerebral venous thrombosis initially presenting with acute subarachnoid hemorrhage.

We report the case of a 44-year-old man with superior sagittal and transverse sinus thrombi, who initially presented with venous subarachnoid hemorrhage over the right parietal sulci. After 7 days of intravenous anticoagulation therapy, his condition stabilized. Cerebral venous thrombosis can be difficult to diagnose and is further complicated when patients initially present with acute subarachnoid hemorrhage.

Prognostic value of electrocorticography findings during callosotomy in children with Lennox-Gastaut syndrome.

Objective: To analyze findings and acute changes in electrocorticograms (ECoGs) obtained during corpus callosotomy in order to identify any relationships with the postoperative outcome of seizure activity.

Methods: We retrospectively analyzed ECoGs obtained during anterior callosotomy (4-6 cm) in 48 patients with Lennox-Gastaut syndrome (32 boys and 16 girls, age 1-20 years, mean age 7.6 years) who underwent surgery between July 1993 and November 1996 to correlate recording findings with postoperative seizure activity.

[Another seizure classification--Semiological Seizure Classification].

The International League Against Epilepsy (ILAE) introduced in 1981 a seizure classification based on clinical semiology, interictal EEG findings, and ictal EEG patterns. Such classification depends heavily on detailed electroclinical correlation. After 20 years' progress in epileptology, many clinicians have found it difficult to make a "definite" seizure diagnosis clinically without a series of electrophysiological examinations, particularly in the infants, and further advancement in epileptology has findings have made the previous classification inefficient.