Page 154 - MEGIN Book Of Abstracts - 2023

Keywords: Interictal spike, Inverse problem, Magnetoen- Endoscopic Total Corpus Callosotomy and Pan
cephalography, Missing problem, Stereo-electroenceph- Commissurotomy for Lennox-Gastaut Syndrome
alography (2022)

NeuroImage (2022), Vol. 254 (35337964) (0 citations) Doddamani, Ramesh; Kota, Ravi Chandra; Ahemad,
Nihal; Chandra, Sarat P; Tripathi, Manjari

Utility of Functional MRI and Department of Neurosurgery, All India Institute of Medical
Magnetoencephalography in the Diagnosis of Sciences (AIIMS), New Delhi, India; Department of Neurol-
Infantile Spasms and Hypsarrhythmia (2022) ogy, All India Institute of Medical Sciences (AIIMS), New Delhi,
India
Coan, Ana Carolina; Cavalcante, Charlington M; Burgess,
Richard C BACKGROUND Corpus callosotomy (CC) is a major
disconnection procedure that functionally isolates
Brazilian Institute of Neuroscience and Neurotechnology the cerebral hemispheres, thereby interrupting the
(BRAINN), at UNICAMP, Campinas, SP, Brazil; and; Epilepsy spread of epileptic activity from one hemisphere to the
Center, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A other. It is extremely useful in children suffering from
non-localized drug refractory epilepsy, especially drop
ABSTRACT Neuroimaging and neurophysiology tech- attacks. The technique has evolved from microscopic
niques can add a significant contribution to the com- to minimally invasive endoscopic surgery. The extent
prehension of infantile spasms (IS) and hypsarrhythmia. of callosotomy also varies based on the institutional
Functional MRI and magnetoencephalography (MEG) practices ranging from anterior 1/3[rd] to total cor-
are two noninvasive tools that can be used in young pus callosotomies (TCC). The performance of TCC in
children with IS. In the past two decades, interesting conjunction with anterior, posterior, and hippocampal
data about IS have emerged from functional MRI and commissurotomies was described for the first time by
MEG studies. Regarding their clinical utility, MEG has the senior author from our institution.
supported the concept that epileptic spasms can have
a focal origin. Moreover, MEG might contribute to the OBJECTIVE To describe the technique of performing
localization of the epileptogenic zone in children with endoscopic total corpus callosotomy, and pan commis-
IS under investigation for epilepsy surgery. Functional surotomy using the interhemispheric corridor.
MRI data have contributed to improve the knowledge
about the physiopathology of IS and hypsarrhythmia. METHODS A seven-year-old right-handed male child
It has demonstrated abnormal brainstem involvement with seizure onset at the age of six months presented
during the high-amplitude slow waves of hypsarrhyth- with three types of semiologies consisting of myo-
mia and cortical involvement during the epileptiform clonic jerks, frequent head drops and tonic posturing
discharges. Since the feasibility of these techniques has involving right upper and lower limbs with secondary
been demonstrated in infants, it is possible that, in the generalization.
future, larger functional MRI and MEG studies might
contribute to the treatment and the definition of the RESULTS Video electroencephalography (VEEG)
long-term prognosis of children with IS. revealed diffuse slowing of the background, and slow
spike and wave pattern. Generalized paroxysmal fast
Journal of clinical neurophysiology: official publication activity (GPFA) was noted in the VEEG, suggestive
of the American Electroencephalographic Society (2022), of LGS. MRI brain revealed bilateral parieto-occipital
Vol. 39, No. 7 (35323155) (0 citations) gliosis and gross brain atrophy. Ictal SPECT localized to
left temporo-occipital area, while magnetoencephalog-
raphy revealed bilateral temporal localization. Patient

 ontents  Index 133
C