Corpus Cullosotomy for Intractable Epilepsy A Case Report

J Korean Neurol Assoc > Volume 8(1); 1990 > Article

Journal of the Korean Neurological Association 1990;8(1): 82-91.

난치성 전간환자에서 시행한 교량체 절단술 ; 1예

이병철, 이병인,허균,허경,정상섭,윤도흠

연세대학교 신경과, 신경외과.

Corpus Cullosotomy for Intractable Epilepsy A Case Report

Byung Chul Lee, M.D., Byung In Lee, M.D., Kyoon Huh, M.D., Hyung Huh,M.D.,Sang Sup Chung, M.D., Do Heum Yoon, M.D

Department of Neurology and Neurolosurgery, Yonsei University, College of Medicine

Abstract

A 20 year-old female underwent an anterior two third corpus callosotomy for the treatment of medically intractable seizures consisting of frequent ictal falls resulted in recurrent head injuries for the past 10 years. Preoperative interictal EEG revealed bilaterally independent multiple foci of epileptiform discharges and slow background rhythm as well as frequent bursts of generalized spike-and-wave complexes. Prolonged video-EEG monitoring demonstrated that the patient's habitual drop seizures were tonic seizures and the patient may also have atypical absence seizures and rare complex partial seizures, Postoperative course was complicated by the development of acute disconnection syndrome consisting of mutism, left lower extremity weakness and urge of urination, which have gradually improved over 4 weeks, She also developed a fever which was subsequently found to be related with postoperative inflammatory lesion. However, her tonic seizures did improve markedly and replaced by occasional brief focal clonic jerks of the left lower extremity The interictal EEG also improved markedly and consisted of only a few episodes of right central spikes and one brrief burst of generalized spike-wave complexes, Neurologic evaluation at one month of operation revealed slightly impaired memory and frontal lobe functions, otherwise unremarkable compared to the preoperative condition, Tbus, we feel that sectioning of the corpus callosum interrupts generalized epileptiform discharges and may be of great benefits in reducing generalized seizures in selected patients with intractable epilepsy.