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Okanishi T, Fujimoto A. Corpus Callosotomy for Controlling Epileptic Spasms: A Proposal for Surgical Selection. Brain Sci 2021; 11:brainsci11121601. [PMID: 34942903 PMCID: PMC8699195 DOI: 10.3390/brainsci11121601] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/30/2021] [Accepted: 11/30/2021] [Indexed: 11/25/2022] Open
Abstract
In 1940, van Wagenen and Herren first proposed the corpus callosotomy (CC) as a surgical procedure for epilepsy. CC has been mainly used to treat drop attacks, which are classified as generalized tonic or atonic seizures. Epileptic spasms (ESs) are a type of epileptic seizure characterized as brief muscle contractions with ictal polyphasic slow waves on an electroencephalogram and a main feature of West syndrome. Resection surgeries, including frontal/posterior disconnections and hemispherotomy, have been established for the treatment of medically intractable ES in patients with unilaterally localized epileptogenic regions. However, CC has also been adopted for ES treatment, with studies involving CC to treat ES having increased since 2010. In those studies, patients without lesions observed on magnetic resonance imaging or equally bilateral lesions predominated, in contrast to studies on resection surgeries. Here, we present a review of relevant literature concerning CC and relevant adaptations. We discuss history and adaptations of CC, and patient selection for epilepsy surgeries due to medically intractable ES, and compared resection surgeries with CC. We propose a surgical selection flow involving resection surgery or CC as first-line treatment for patients with ES who have been assessed as suitable candidates for surgery.
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Affiliation(s)
- Tohru Okanishi
- Division of Child Neurology, Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan;
- Correspondence: ; Tel.: +81-859-38-67721; Fax: +81-859-38-6770
| | - Ayataka Fujimoto
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan;
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Peng BW, Li XJ, Wu WX, Zeng YR, Liao YT, Hou C, Liang HC, Zhang W, Wang XY, Chen WX. The Possible Role of Hypothalamus-Pituitary-Adrenal Dysfunction in Epileptic Spasms. Seizure 2020; 81:145-150. [DOI: 10.1016/j.seizure.2020.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022] Open
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Iimura Y, Jones K, Takada L, Shimizu I, Koyama M, Hattori K, Okazawa Y, Nonoda Y, Asano E, Akiyama T, Go C, Ochi A, Snead OC, Donner EJ, Rutka JT, Drake JM, Otsubo H. Strong coupling between slow oscillations and wide fast ripples in children with epileptic spasms: Investigation of modulation index and occurrence rate. Epilepsia 2018; 59:544-554. [PMID: 29315516 DOI: 10.1111/epi.13995] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Epileptic spasms (ES) often become drug-resistant. To reveal the electrophysiological difference between children with ES (ES+) and without ES (ES-), we compared the occurrence rate (OR) of high-frequency oscillations (HFOs) and the modulation index (MI) of coupling between slow and fast oscillations. In ES+, we hypothesized that (1) pathological HFOs are more widely distributed and (2) slow oscillations show stronger coupling with pathological HFOs than in ES-. METHODS We retrospectively reviewed 24 children with drug-resistant multilobar onset epilepsy, who underwent intracranial video electroencephalography prior to multilobar resections. We measured the OR of HFOs and determined the electrodes with a high rate of HFOs by cluster analysis. We calculated MI, which reflects the degree of coupling between HFO (ripple/fast ripple [FR]) amplitude and 5 different frequency bands of delta and theta activities (0.5-1 Hz, 1-2 Hz, 2-3 Hz, 3-4 Hz, 4-8 Hz). RESULTS In ES+ (n = 10), the OR(FRs) , the number of electrodes with high-rate FRs, and the MI(FRs & 3-4 Hz) in all electrodes were significantly higher than in ES- (n = 14). In both the ES+ and ES- groups, MI(ripples/FRs & 3-4 Hz) was the highest among the 5 frequency bands. Within the good seizure outcome group, the OR(FRs) and the MI(FRs & 3-4 Hz) in the resected area in ES+ were significantly higher than in ES- (OR[FRs] , P = .04; MI[FRs & 3-4 Hz] , P = .04). SIGNIFICANCE In ES+, the larger number of high-rate FR electrodes indicates more widespread epileptogenicity than in ES-. High values of OR(FRs) and MI(FRs & 3-4 Hz) in ES+ compared to ES- are a signature of the severity of epileptogenicity. We proved that ES+ children who achieved seizure freedom following multilobar resections exhibited strong coupling between slow oscillations and FRs.
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Affiliation(s)
- Yasushi Iimura
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kevin Jones
- Division of Neurology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Lynne Takada
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Itsuki Shimizu
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Misaki Koyama
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kyoko Hattori
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Yushi Okazawa
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Yutaka Nonoda
- Pediatrics and Neurology, Children's Hospital of Michigan, Wayne State University, Detroit, MI, USA
| | - Eishi Asano
- Pediatrics and Neurology, Children's Hospital of Michigan, Wayne State University, Detroit, MI, USA
| | - Tomoyuki Akiyama
- Department of Child Neurology, Okayama University Hospital, Okayama, Japan
| | - Cristina Go
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ayako Ochi
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - O Carter Snead
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elizabeth J Donner
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - James T Rutka
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - James M Drake
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Hiroshi Otsubo
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
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Sakuma S, Halliday WC, Nomura R, Baba S, Sato Y, Okanari K, Nakajima M, Widjaja E, Boelman C, Ochi A, Snead OC, Rutka JT, Drake J, Miller S, Otsubo H. Increased subcortical oligodendroglia-like cells in pharmacoresistant focal epilepsy in children correlate with extensive epileptogenic zones. Epilepsia 2016; 57:2031-2038. [DOI: 10.1111/epi.13590] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2016] [Indexed: 02/04/2023]
Affiliation(s)
- Satoru Sakuma
- Division of Neurology; The Hospital for Sick Children; Toronto Ontario Canada
- Department of Pediatrics; Osaka City University Graduate School of Medicine; Osaka Osaka Japan
| | - William C. Halliday
- Division of Pathology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Ruka Nomura
- Division of Neurology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Shiro Baba
- Division of Neurology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Yosuke Sato
- Division of Neurology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Kazuo Okanari
- Division of Neurology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Midori Nakajima
- Division of Neurology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Elysa Widjaja
- Division of Diagnostic Imaging; The Hospital for Sick Children; Toronto Ontario Canada
| | - Cyrus Boelman
- Division of Neurology; BC Children's Hospital; Vancouver British Columbia Canada
| | - Ayako Ochi
- Division of Neurology; The Hospital for Sick Children; Toronto Ontario Canada
| | - O. Carter Snead
- Division of Neurology; The Hospital for Sick Children; Toronto Ontario Canada
| | - James T. Rutka
- Department of Neurosurgery; The Hospital for Sick Children; Toronto Ontario Canada
| | - James Drake
- Department of Neurosurgery; The Hospital for Sick Children; Toronto Ontario Canada
| | - Steven Miller
- Division of Neurology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Hiroshi Otsubo
- Division of Neurology; The Hospital for Sick Children; Toronto Ontario Canada
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Kobayashi K, Akiyama T, Oka M, Endoh F, Yoshinaga H. Fast (40-150Hz) oscillations are associated with positive slow waves in the ictal EEGs of epileptic spasms in West syndrome. Brain Dev 2016; 38:909-914. [PMID: 27259671 DOI: 10.1016/j.braindev.2016.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 05/18/2016] [Accepted: 05/19/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To elucidate the generative mechanisms of epileptic spasms (ESs) in West syndrome, we investigated the temporal relationship between scalp fast (40-150Hz) oscillations (FOs) and slow waves in the ictal electroencephalograms (EEGs) of ESs. METHODS In 11 infants with WS, ictal FOs were detected in a bipolar montage based on spectral and waveform criteria. Their temporal distribution was analyzed in terms of the positive peaks (trough point, TT) of identical EEG data in a referential montage. Among six EEG data sections defined according to TT, the number of FOs, peak power values, and peak frequencies were compared. RESULTS We identified a total of 1014 FOs (946 gamma and 68 ripple oscillations), which clustered closely at TT. The number of gamma oscillations in the 1s epoch including TT was significantly higher than those in the prior and subsequent phases. Peak power values and frequencies tended to be higher in these positive phase sections. CONCLUSIONS The temporal association of FO clustering and positive slow waves in the ictal EEGs of ES indicated that active neuronal firing related to FOs underlies the generation of ESs and their ictal slow waves.
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Affiliation(s)
- Katsuhiro Kobayashi
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital, Okayama, Japan.
| | - Tomoyuki Akiyama
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital, Okayama, Japan
| | - Makio Oka
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital, Okayama, Japan
| | - Fumika Endoh
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital, Okayama, Japan
| | - Harumi Yoshinaga
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital, Okayama, Japan
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