Case Report
Volume 12 Issue 10 - 2020
Posterolateral Disconnection as an Effective Technique in Drug Refractory Epilepsy - A Case Report and Review of Literature
Sibhi Ganapathy* and Lingaraju T
Neurosurgeon and Spine Surgeon, Sakra World Hospital, Bangalore, India
*Corresponding Author: Sibhi Ganapathy, Neurosurgeon and Spine Surgeon, Sakra World Hospital, Bangalore, India.
Received: May 26, 2020; Published: September 30, 2020




Abstract

Refractory epilepsy surgeries have evolved over the years from resection to disconnection procedures reducing the perioperative morbidities and long-term complications, while yielding good outcomes. We present a child with medically refractory Epilepsy which hemiparesis and hemianopia. The imaging was suggestive of extensive posterior quadrant gliosis secondary to neonatal asphyxia. After successful seizure localisation, using phase 1 and 2 investigations, a posterior quadrant disconnection was successfully carried out without incident. The child recovered and is seizure free with no additional deficits. Posterior quadrant disconnection surgery accounts for less than 5% of overall epilepsy surgeries and is less frequently described in literature. Yet it has become more acceptable to neurosurgeons and patients alike over the years. A quick review of literature is also supplied

Keywords: Posterior Quadrant Disconnection; Medically Recalcitrant Epilepsy

References

  1. Rasmussen T. “Hemispherectomy for seizures revisited”. Canadian Journal of Neurological Sciences 10 (1983): 71-78.
  2. Mohamed AR., et al. “Temporoparietooccipital disconnection in children with intractable epilepsy”. Journal of Neurosurgery Pediatrics 7 (2011): 660-670.
  3. Källén K., et al. “Hypomotor seizures in infants and children”. Epilepsia 43 (2002): 882-888.
  4. Fogarasi A., et al. “A detailed analysis of symptomatic posterior cortex seizure semiology in children younger than seven years”. Epilepsia 44 (2003): 89-96.
  5. D’Agostino MD., et al. “Posterior quadrantic dysplasia or hemi-hemimegalencephaly: A characteristic brain malformation”. Neurology 62 (2004): 2214-2220.
  6. Wyllie E., et al. “Successful surgery for epilepsy due to early brain lesions despite generalized EEG findings”. Neurology 69 (2007): 389-397.
  7. Novegno F., et al. “Epilepsy surgery of posterior quadrant dysplasia in the first year of life: Experience of a single centre with long term follow-up”. Seizure 20 (2011): 27-33.
  8. Lee YJ., et al. “Resective pediatric epilepsy surgery in Lennox-Gastaut syndrome”. Pediatrics 125 (2010): e58-e66.
  9. Kramer U., et al. “Focal features in West syndrome indicating candidacy for surgery”. Pediatric Neurology 16 (1997): 213-217.
  10. Chugani HT., et al. “Infantile spasms: I. PET identifies focal cortical dysgenesis in cryptogenic cases for surgical treatment”. Annals of Neurology 27 (1990): 406-413.
  11. Gupta A., et al. “Pediatric epilepsy surgery in focal lesions and generalized electroencephalogram abnormalities”. Pediatric Neurology 37 (2007): 8-15.
  12. Morrell F. “Varieties of human secondary epileptogenesis”. Journal of Clinical Neurophysiology 6 (1989): 227-275.
  13. Daniel RT., et al. “Posterior quadrantic epilepsy surgery: Technical variants, surgical anatomy, and case series”. Epilepsia 48 (2007): 1429-1437.
  14. Boesebeck F., et al. “Lateralizing semiology predicts the seizure outcome after epilepsy surgery in the posterior cortex”. Brain 125 (2002): 2320-2331.
  15. Jehi LE., et al. “A longitudinal study of surgical outcome and its determinants following surgery”. Epilepsia 50 (2009): 2040-2052.
  16. Agha RA., et al. “For the SCARE Group. The SCARE 2018 Statement: Updating Consensus Surgical CAse REport (SCARE) Guidelines”. International Journal of Surgery 60 (2018): 132-136.
Citation: Sibhi Ganapathy and Lingaraju T. “Posterolateral Disconnection as an Effective Technique in Drug Refractory Epilepsy - A Case Report and Review of Literature”. EC Neurology 12.10 (2020): 86-95.

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