Effects of Corpus Callosotomy and Subsequent Disconnection Surgery in Late-onset Epileptic Spasm Comparing Post-encephalitis/encephalopathy and Non-encephalitis/encephalopathy
Abstract number :
1.322
Submission category :
9. Surgery / 9B. Pediatrics
Year :
2023
Submission ID :
15
Source :
www.aesnet.org
Presentation date :
12/2/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Takeshi Inoue, MD – Osaka City General Hospital
Ichiro Kuki, MD – Department of Pediatric Neurology – Osaka City General Hospital; Takehiro Uda, MD – Department of Neurosurgery – Osaka Metropolitan University Graduate School of Medicine; Noritsugu Kunihiro, MD – Department of Neurosurgery – Osaka City General Hospital; Ryoko Umaba, MD – Department of Pediatric Neurosurgery – Osaka City General Hospital; Saya Koh, MD – Department of Neurosurgery – Osaka Metropolitan University Graduate School of Medicine; Naohiro Yamamoto, MD – Department of Pediatric Neurology – Osaka City General Hospital; Megumi Nukui, MD – Department of Pediatric Neurology – Osaka City General Hospital; Shin Okazaki, MD – Department of Pediatric Neurology – Osaka City General Hospital; Hiroshi Otsubo, MD – Division of Neurology – The Hospital for Sick Children
Rationale: Late-onset epileptic spasms (LOES) are defined as epileptic spasms (ES) that start after the first year of life. We aimed to analyze the efficiency of corpus callosotomy (CC) and subsequent disconnection surgeries in patients with LOES by comparing post-encephalitis/encephalopathy (PE) and non-encephalitis/encephalopathy (NE). We hypothesized these surgeries can control potential focal onset epileptic spasms (ES) in the NE group but not in the PE group.
Methods: We collected a total of 84 patients with LOES (20 PE and 64 NE) at Osaka City General Hospital from 1995 to 2021 (Figure 1). 23/84 (27%) patients (12 PE and 11 NE) initially underwent CC and subsequent disconnection surgeries (5 NE). We compared the etiologies, clinical courses, seizure types, MRI, video-EEG, epilepsy surgery, and seizure outcomes between the two groups.
Results: The median age of LOES onset was 2.5 years (1.0–16.8) in a total of 84 patients, 2.8 years (1.0–10.1) in PE group, and 2.9 years (1.1–12.6) in NE group. Bilateral MRI abnormalities were observed in both groups (PE, n = 12; NE, n = 3; P< 0.05). PE group presented ES alone (n=2), ES+focal seizures (FS) (n = 3), ES+generalized seizures (GS) (n = 3), and ES+FS+GS (n = 4) in addition to stimulus-induced startle seizures (SS) (n = 8) (mean 3.1 seizure types/patient). NE group presented ES alone (n = 1), ES+FS (n = 2), and ES+FS+GS (n = 8) (mean 2.7 seizure types/patient). In PE group, CC stopped ES (n = 1). CC achieved >
Surgery