1990 Volume 8 Issue 1 Pages 54-60
We report a case of medically intractable Lennox-Gastaut syndrome who was successfully treated with the anterior callosotomy. After he experienced status epilepticus at the age of 14 years, his seizures evolved generalized tonic-clonic seizure, atypical absence, drop attack, and myoclonus of both hands for following 21 years. Despite administration of various anticonvulsats, his seizures became more frequent. At the age of 35 years, he admitted our hospital. Preoperative EEGs showed diffuse slow spike and wave dominantly in the frontal, parietal and temporal regions. MRI was normal except for mild diffuse brain atropy. Anterior callosotomy was performed under monitoring of transcallosal response (TCR) by stimultion of the corpus callosum to identify the commissural fiber. During postoperative follow-up periods for 9 months, marked reduction of drop attack, atypical absence, and generalized tonic-clonic seizure was observed. Postoperative EEGs showed lateralization of slow spike and wave discharges to the right central region.
Intraoperative monitoring of TCR was useful method for identification of the caudal portion during partial callosotomy. Indication of the callosotomy and possible mechanism of the corpus callosum in epilepsy were discussed.
