Eight patients with secondary generalized epilepsy not alleviated by medical treatment underwent partial callosotomy. During the surgical procedure, they had mesial surface ECoG recordings taken from both frontal and parietal lobes, using large flat multilead platinum electrodes, and simultaneously recordings from a number of scalp positions, using needle electrodes. In all cases studied, this approach demonstrated one or, more commonly, several focal areas of epileptiform activity discharging independently over the mesial aspects of one or both hemispheres. The findings were correlated with the pre- and postoperative EEG patterns, in the light of current concepts of generalized epilepsies.
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http://dx.doi.org/10.1159/000099975 | DOI Listing |
Front Neurol
December 2024
Brain and Development Research Axis, Azrieli CHU Ste-Justine Research Center, Montreal, QC, Canada.
Epileptic spasms (ES) are a unique seizure type typically presenting in the form of infantile epileptic spasms syndrome (IESS) with characteristic hypsarrhythmia on scalp EEG and a preponderance with developmental delay or regression. While pharmacotherapy is the mainstay of treatment, surgical options, including disconnective or resective procedures, are increasingly recognized as viable therapeutic options for recurrent or persistent ES. However, limited data on safety, effectiveness, and prognostic factors hinder informed decision-making regarding surgery indications, timing, and intervention type.
View Article and Find Full Text PDFMalformation of cortical development is an important cause of drug-resistant epilepsy in young children. Mild malformation of cortical development with oligodendroglial hyperplasia in epilepsy (MOGHE) has been added to the last focal cortical dysplasia (FCD) classification and commonly involves the frontal lobe. The semiology at the onset of epilepsy is dominated by non-lateralizing infantile spasm; the boundaries of the malformation are usually difficult to determine by magnetic resonance imaging (MRI) and positron emission tomography (PET), and electroencephalography (EEG) findings are often widespread.
View Article and Find Full Text PDFFront Physiol
July 2024
Electron Microscopy Unit, Azienda Ospedaliero-Universitaria, Ancona, Italy.
The corpus callosum-the largest commissural fiber system connecting the two cerebral hemispheres-is considered essential for bilateral sensory integration and higher cognitive functions. Most studies exploring the corpus callosum have examined either the anatomical, physiological, and neurochemical organization of callosal projections or the functional and/or behavioral aspects of the callosal connections after complete/partial callosotomy or callosal lesion. There are no works that address the intrinsic organization of the corpus callosum.
View Article and Find Full Text PDFWorld Neurosurg
September 2024
Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan.
Hemispherotomy is a surgical procedure aimed at the treatment of hemispheric epilepsy. Hemispherotomy disconnects the commissural fibers, projecting fibers, and limbic system while preserving most of the brain parenchyma, unlike conventional hemispherectomy. Hemispherotomy is one of most complicated operations currently used in epilepsy surgery and requires a high-level understanding of the intrinsic neuroanatomy.
View Article and Find Full Text PDFBrain Res
August 2024
Section for Cognitive and Clinical Neuroscience, Department of Psychology, University of Oslo, Oslo, Norway. Electronic address:
The right-ear advantage (REA) for recalling dichotically presented auditory-verbal stimuli has been traditionally linked to the dominance of the left cerebral hemisphere for speech processing. Early studies on patients with callosotomy additionally found that the removal of the corpus callosum leads to a complete extinction of the left ear, and consequently the today widely used models to explain the REA assume a central role of callosal axons for recalling the left-ear stimulus in dichotic listening. However, later dichotic-listening studies on callosotomy patients challenge this interpretation, as many patients appear to be able to recall left-ear stimuli well above chance level, albeit with reduced accuracy.
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