Multiple subpial transection

Bermeo‐Ovalle, Adriana; Smith, Michael C.

doi:10.1002/9781118936979.ch72

The Treatment of Epilepsy 2015

DOI: 10.1002/9781118936979.ch72

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Multiple subpial transection

Adriana Bermeo‐Ovalle

Michael C. Smith²

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2024

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Multiple Subpial Transection for the Treatment of Landau–Kleffner Syndrome—Review of the Literature

Duda,

Kostelecka

et al. 2024

JCM

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As speech-related symptoms of Landau–Kleffner syndrome (LKS) are often refractory to pharmacotherapy, and resective surgery is rarely available due to the involvement of the vital cortex, multiple subpial transection (MST) was suggested to improve patient outcome and preserve cortical functions. Here, we analyze the reports about MST use in LKS, regarding its impact on seizures, language, behavior, EEG, cognition, and reported adverse effects. In conditions like LKS, surgery is not a popular treatment option and presumably should be considered sooner. Candidates for MST should be selected carefully, optimally with the unilateral onset of epileptic activity. Laterality can be assessed using a methohexital suppression test (MHXT), electrical intracarotid amobarbital test, or magnetoencephalography. After MST, a significant percentage of LKS patients present seizure-free status, normalization of EEG patterns, and rapid behavior improvement. Data comprising language outcomes are mixed, with improvement reported in 23.8–100% of cases, and no superiority was found in the only study comparing MST with a non-surgical group. Cognitive outcomes are not well described. The risk linked to MST is described as low, with cerebral edema and transient neurological deficits being the most common complications. MST successfully improves seizure, EEG, and behavioral outcomes in LKS patients. However, its beneficial impact on language and cognition is not well proven. It is generally a safe neurological operation.

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Multiple Subpial Transection for the Treatment of Landau–Kleffner Syndrome—Review of the Literature

Duda,

Kostelecka

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

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Multiple subpial transection

Cited by 1 publication

References 42 publications

Multiple Subpial Transection for the Treatment of Landau–Kleffner Syndrome—Review of the Literature

Multiple Subpial Transection for the Treatment of Landau–Kleffner Syndrome—Review of the Literature

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