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Partial disconnection procedure in a patient with bilateral lesions (case report).

Stepanenko AY, Arkhipova NA, Pronin IN, Shishkina LV, Lebedeva AV, Guekht AB - Epilepsy Behav Case Rep (2013)

Bottom Line: Histological examination of the cortex revealed CD type I.The patient has been seizure-free for 4 years after surgery.Partial disconnection procedures may be effective in cases where total hemispherotomy is not indicated in patients with bilateral lesions and a well-lateralized epileptogenic zone localized in the temporo-parieto-occipital region.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Moscow City Hospital No. 12, 26 Bakinskaya Street, Moscow 115516, Russian Federation.

ABSTRACT

Purpose: The method of temporal lobectomy and parietooccipital disconnection has been applied in the treatment of patients with monolateral widespread cortical lesions and with hand motor function intact. There are no data regarding the use of this method in the treatment of patients with bilateral lesions.

Case report: A case history of a 15-year-old female patient with medically refractory epilepsy is presented. Magnetic resonance imaging revealed bilateral periventricular nodular heterotopia associated with cortical dysplasia (CD) in the right temporo-parietal region. The left hemisphere had no signs of CD. Invasive monitoring revealed rhythmic theta-delta activity during the interictal period and fast activity during the ictal onset in the right temporal and parietal regions. The surgery procedure consisted of anterior temporal lobectomy, the removal of the right heterotopy nodus, the dissection of the posterior part of the corpus callosum, and the detachment of the temporo-parieto-occipital complex by dissection behind the sensorimotor cortex. Histological examination of the cortex revealed CD type I. The patient has been seizure-free for 4 years after surgery.

Conclusion: Partial disconnection procedures may be effective in cases where total hemispherotomy is not indicated in patients with bilateral lesions and a well-lateralized epileptogenic zone localized in the temporo-parieto-occipital region.

No MeSH data available.


Related in: MedlinePlus

Postoperative MRI. Volume of surgical intervention (described in the text of the article).
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f0015: Postoperative MRI. Volume of surgical intervention (described in the text of the article).

Mentions: The surgery procedure consisted of anterior temporal lobectomy and the opening of the posterior part of the temporal horn by dissection through the medial margin of the superior temporal gyrus to the trigonum, the removal of the right heterotopy nodus, the dissection of the parahippocampal gyrus and the medial part of the parietal lobe at the level of the posterior part of the ambiens cistern, the dissection of the posterior part of the corpus callosum, and the detachment of the temporo-parieto-occipital complex by dissection through the white matter of the parietal lobe just behind the sensorimotor cortex (Fig. 3).


Partial disconnection procedure in a patient with bilateral lesions (case report).

Stepanenko AY, Arkhipova NA, Pronin IN, Shishkina LV, Lebedeva AV, Guekht AB - Epilepsy Behav Case Rep (2013)

Postoperative MRI. Volume of surgical intervention (described in the text of the article).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4150654&req=5

f0015: Postoperative MRI. Volume of surgical intervention (described in the text of the article).
Mentions: The surgery procedure consisted of anterior temporal lobectomy and the opening of the posterior part of the temporal horn by dissection through the medial margin of the superior temporal gyrus to the trigonum, the removal of the right heterotopy nodus, the dissection of the parahippocampal gyrus and the medial part of the parietal lobe at the level of the posterior part of the ambiens cistern, the dissection of the posterior part of the corpus callosum, and the detachment of the temporo-parieto-occipital complex by dissection through the white matter of the parietal lobe just behind the sensorimotor cortex (Fig. 3).

Bottom Line: Histological examination of the cortex revealed CD type I.The patient has been seizure-free for 4 years after surgery.Partial disconnection procedures may be effective in cases where total hemispherotomy is not indicated in patients with bilateral lesions and a well-lateralized epileptogenic zone localized in the temporo-parieto-occipital region.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Moscow City Hospital No. 12, 26 Bakinskaya Street, Moscow 115516, Russian Federation.

ABSTRACT

Purpose: The method of temporal lobectomy and parietooccipital disconnection has been applied in the treatment of patients with monolateral widespread cortical lesions and with hand motor function intact. There are no data regarding the use of this method in the treatment of patients with bilateral lesions.

Case report: A case history of a 15-year-old female patient with medically refractory epilepsy is presented. Magnetic resonance imaging revealed bilateral periventricular nodular heterotopia associated with cortical dysplasia (CD) in the right temporo-parietal region. The left hemisphere had no signs of CD. Invasive monitoring revealed rhythmic theta-delta activity during the interictal period and fast activity during the ictal onset in the right temporal and parietal regions. The surgery procedure consisted of anterior temporal lobectomy, the removal of the right heterotopy nodus, the dissection of the posterior part of the corpus callosum, and the detachment of the temporo-parieto-occipital complex by dissection behind the sensorimotor cortex. Histological examination of the cortex revealed CD type I. The patient has been seizure-free for 4 years after surgery.

Conclusion: Partial disconnection procedures may be effective in cases where total hemispherotomy is not indicated in patients with bilateral lesions and a well-lateralized epileptogenic zone localized in the temporo-parieto-occipital region.

No MeSH data available.


Related in: MedlinePlus