Effect of Anterior Callosotomy on Bilaterally Synchronous Spike and Wave and Other EEG Discharges

Oguni, Hirokazu; Andermann, Frédérick; Gotman, Jean; Olivier, André

doi:10.1111/j.1528-1157.1994.tb02469.x

Cited by 52 publications

(34 citation statements)

References 24 publications

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“…Short-and long-term results of corpus callosotomy have been previously reported by our group. 18,19,50 Again, no prophylactic antibiotic agents were used before or after surgery.…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…It has been demonstrated that the incidence of disconnection syndrome is increased as the extent of callosal section increases, and it has been reported up to 3% in total callosotomy. 45 However, some clinical studies 11,47 and our own experience 18,19,50 have suggested that staged sectioning could avoid disconnection syndrome.…”

Section: Neurological Complicationsmentioning

confidence: 99%

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Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution

Tanrıverdi¹,

Ajlan²,

Poulin³

et al. 2009

JNS

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131

108

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Object. In this paper the authors aimed to provide information related to major and minor surgical and neurological complications encountered following stereoelectroencephalography and epilepsy surgery.Methods. The authors performed a retrospective review of 491 and 1905 patients who underwent intracranial electrode implantation and epilepsy surgery, respectively, between 1976 and 2006 at the Montreal Neurological Institute. All intracranial electrode implantations and surgical procedures were performed by 1 surgeon (A.O.).Results. A total of 6415 electrode implantations and 2449 surgical procedures were done. There were no deaths related to either procedure. There were no major complications after intracranial electrode implantation, and the risks of infection and intracranial hematoma were found to be 1.8 and 0.8%, respectively. The number of electrodes per lobe (p = 0.05) and number of lobes covered (p = 0.04) were significant risk factors for hematoma and infection. Regarding epilepsy surgery, there were no major surgical complications, and the overall minor complication rate was 2.9%. Infection was the most common complication (1.0%), followed by intracranial hematoma (0.7%). Significant risk factors associated with hematomas and infections were the number of reoperations (p = 0.001) and older patient age (p = 0.03). Minor and major neurological complication rates were 2.7 and 0.5%, respectively, and the rate of overall neurological morbidity was 3.3%. Hemiparesis was the most frequent neurological complication (1.5%).Conclusions. Based on the authors' experience, intracranial electrode implantation is an effective method with an extremely low morbidity rate. Moreover, epilepsy surgery is safe, especially in experienced hands. (DOI: 10.3171/2009.8.JNS08338) Key Words • complication • epilepsy • epilepsy surgery • intracranial electrode • morbidity 1111Abbreviations used in this paper: CAH = corticoamygdalohippocampectomy; DVT = deep vein thrombosis; EDH = epidural hematoma; IPH = intraparenchymal hematoma; MNI = Montreal Neurological Institute; PE = pulmonary embolism; QOL = quality of life; SDH = subdural hematoma; SEEG = stereoelectroencephalography; TLE = temporal lobe epilepsy; VFD = visual field defect.

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“…Short-and long-term results of corpus callosotomy have been previously reported by our group. 18,19,50 Again, no prophylactic antibiotic agents were used before or after surgery.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Section: Neurological Complicationsmentioning

confidence: 99%

Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution

Tanrıverdi¹,

Ajlan²,

Poulin³

et al. 2009

JNS

Self Cite

131

108

View full text Add to dashboard Cite

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“…Electroencephalogram (EEG) changes reported after CCs consist of a disruption of bilateral synchrony associated with amplitude asymmetry, localization or lateralization of seizure discharges, and the appearance of bilaterally independent spike-waves (BISWs) (3,(12)(13)(14)(15). However, the relation Accepted February 25, 1999.…”

Section: Discussionmentioning

confidence: 99%

“…They also found that ictal EEG changes after CC were more consistent with the lateralization of the observed clinical seizures (17). Oguni et al (15) reported that there was a significant relation between surgical outcome and postoperative decreases in the amount of interictal generalized spike-waves and that the degree of disruption of synchrony along with the total amount of epileptic discharges and the preoperative and postoperative EEG patterns were not good indicators of surgical outcome. Baba et al (18) reported that a marked lateralization of diffuse slow spike waves to the unilateral hemisphere in postoperative EEGs implied a better prognosis than bilaterally independent spike waves.…”

Section: -02 T3-t4mentioning

confidence: 99%

Quantitative EEG Analyses and Surgical Outcome After Corpus Callosotomy

et al. 1999

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Summary: Purpose: To clarify the relation between quantitative electroencephalogram (EEG) findings and outcome following corpus callosotomy (CC).Methods: The degree of bilateral synchrony and morphologic similarity of spike-wave discharges was analyzed by using a cross-correlation analysis and the measurements of amplitude differences between bilateral homologous regions in 22 patients who underwent anterior CCs for intractable symptomatic generalized epilepsies (SGE; 17 patients) and frontal lobe epilepsy (five patients).Results: Interictal generalized synchronous spike-wave (GSSW) bursts in the SGE patients were disrupted and changed to unilateral spike-waves (USWs) in 11 patients and to bilaterally independent spike-waves (BISWs) in six. The USW group had better surgical outcome than the BISW group. Preoperatively, the USW group had significantly lower interhemispheric synchrony (IS) and fewer regional changes in the side leading in time and the side dominant for amplitude, suggesting unilaterally predominant epileptogenesis that triggered the secondary bilateral synchrony. Postoperatively, the BISW group had a more marked reduction in IS because of independent discharges from bilateral epileptogenic areas, and the USW group had a greater amplitude difference because of unilateralized spike-waves. In addition, an excellent surgical outcome was related to (a) the preoperative degree of the morphologic similarity of the bilateral spike-waves (only a small variation during a burst of spike-waves) and the few instances of regional changes in the side leading in time and in the side dominant for amplitude; and (b) to large postoperative amplitude differences.Conclusion: Preoperative quantitative EEG analyses enabled us to predict the underlying conditions of epileptogenesis and the surgical outcomes in patients undergoing CC. Key Words: Corpus callosotomy-Epilepsy-Cross-correlation analysis-EEG-Surgical outcome.Because the corpus callosum is thought to be a major pathway in the bilateral generalization of seizure discharges, corpus callosotomies (CCs) have been performed to reduce the frequency and severity of intractable seizures, especially secondarily generalized seizures, and they have provided a marked improvement in seizure control for many patients (1-1 1). Electroencephalogram (EEG) changes reported after CCs consist of a disruption of bilateral synchrony associated with amplitude asymmetry, localization or lateralization of seizure discharges, and the appearance of bilaterally independent spike-waves (BISWs) (3,(12)(13)(14)(15). However, the relation Accepted February 25, 1999.Address correspondence and reprint requests to Dr. T. Matsuzaka at Department of Pediatrics, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852, Japan. E-mail: neuro@net.nagasaku.ac.jp between these EEG changes and patients' surgical outcome has not been clarified, in part because of a lack of quantitative data on the EEG changes. Therefore we analyzed the degree of bilateral synchrony and morphologic similarity o...

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“…Interictal scalp EEG may have no predictive value for the outcome of callosotomy. 16,19) Statistical study has shown a correlation between preoperative quantitative EEG and surgical outcome, 5,6,12) but the EEG selection criteria for individuals remains questionable. Magnetoencephalography (MEG) is known to have higher spatial resolution than EEG because of the negligible distortion caused by the head conductivity.…”

Section: Meg and Callosotomymentioning

confidence: 99%

Evaluation of Interhemispheric Time Difference by Magnetoencephalography Before and After Total Callosotomy-Two Case Reports-

Salayev

Nakasato

Ishitobi

et al. 2006

Neurol. Med. Chir.(Tokyo)

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Interhemispheric time difference (ITD) measured by electroencephalography (EEG) and magnetoencephalography (MEG) was compared to seizure outcome after callosotomy. Two patients with frequent drop attacks underwent simultaneous EEG and MEG before and after total callosotomy. ITDs in 30 bilateral synchronized (BS) discharges were calculated independently by EEG and MEG. As minimum transcallosal conduction time was suggested to be approximately 20 msec, BS discharges were classified into five categories according to ITD and side: left-or right-leading long (300 to 80 msec), left-or right-leading moderate (80 to 20 msec), and negligible (º20 msec). In Case 1 before callosotomy, EEG detected 77% negligible and 23% right-leading moderate BS discharges, whereas MEG detected 30% and 63%, respectively. After callosotomy, drop attacks reduced remarkably and EEG and MEG detected no BS discharges. In Case 2 before callosotomy, EEG detected 77% negligible and 23% moderate BS discharges, whereas MEG detected 80% and 20%, respectively. After callosotomy, drop attacks recurred 2 months later and EEG and MEG detected left-and right-leading long BS discharges (63% by EEG and 56% by MEG). MEG detected a large number of BS discharges with moderate ITD before surgery in Case 1, suggesting that the transcallosal pathway was the main pathway for the synchronization, whereas the negligible ITD in Case 2 excludes transcallosal propagation. BS discharges with longer ITD after surgery in Case 2 suggest a persistent poly-synaptic non-transcallosal pathway. MEG with higher spatial resolution than EEG may provide surgical indications for callosotomy.

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Effect of Anterior Callosotomy on Bilaterally Synchronous Spike and Wave and Other EEG Discharges

Cited by 52 publications

References 24 publications

Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution

Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution

Quantitative EEG Analyses and Surgical Outcome After Corpus Callosotomy

Evaluation of Interhemispheric Time Difference by Magnetoencephalography Before and After Total Callosotomy-Two Case Reports-

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