Abstract
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.
Highlights
Epileptic spasms (ES), which are the epileptic seizures commonly associated with West syndrome, are characterized by brief muscle contractions that typically involve the trunk and limbs
We investigated the correlation between ES-BMC, which were defined as ES with biphasic spastic muscular contractions and polyphasic ictal high-voltage slow waves (HVSs), and CC outcomes
Seizure semiology of ES-BMC primarily involved unilateral movement, which is suggestive of negligible involvement of the corpus callosum
Summary
Epileptic spasms (ES), which are the epileptic seizures commonly associated with West syndrome, are characterized by brief muscle contractions that typically involve the trunk and limbs. ES is associated with typical ictal electroencephalogram (EEG) patterns, including fast waves bursts, high-voltage slow waves (HVSs), and desynchronization [1,2,3]. ES-associated electromyogram (EMG) activity exhibits rhombus patterns, whereby activity quickly reaches a peak and decreases [1, 2]. ES are often medically intractable, and therapeutic approaches, including antiepileptic drugs (AEDs), adrenocorticotropic hormone therapy, and surgical treatments, have been discussed in many studies. The treatment strategy for drug-resistant ES has not been integrated.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
