[P2-108] Successful Corpus Callosotomy for a Child with Refractory Myoclonic Seizures in Doose Syndrome
Objective: Corpus callosotomy (CC) is a valuable palliative surgical option for children with medically refractory seizure of drop attacks. However, there have been only a few reports of CC for the patients suffering from refractory myoclonic seizures. We describe a patient of Doose syndrome who showed refractory frequent myoclonic seizures. Anterior CC markedly reduced the seizures.
Patient: Patient is an 10-year-old boy. He developed myoclonic astatic seizures, tonic seizures, myoclonic seizures, and generalized tonic clonic seizures from 3-year old. Although myoclonic astatic seizures disappeared with valproate and clonazepam, other seizures continued. He was referred to Seirei Hamamatsu General Hospital at 8-year and 3-month old. A brain-MRI showed no suspicious epileptogenic lesions. Total 24 hours of video-EEG monitoring revealed parietal dominant bilateral theta activity and diffuse high amplitude spike & wave burst, interictally. Bilateral myoclonic seizures with high amplitude spike or polyspike & wave were captured over 100 times during drowsiness and sleep. He was undergone anterior four fifth CC at 8-year and 5-month old. His myoclonic seizures decreased to a few times a month. We added vagus nerve stimulation (VNS) therapy for his residual seizures at 9-year and 1-month old. Interictal EEG did not show epileptiform discharges at 10-year and 6-month old. At the last follow up at 10-year and 10-month old, only simple partial seizures once a month remained.
Discussion: CC might be a valuable option for patients with medically refractory myoclonic seizures which are thought to be associated with interhemispheric interaction.
Patient: Patient is an 10-year-old boy. He developed myoclonic astatic seizures, tonic seizures, myoclonic seizures, and generalized tonic clonic seizures from 3-year old. Although myoclonic astatic seizures disappeared with valproate and clonazepam, other seizures continued. He was referred to Seirei Hamamatsu General Hospital at 8-year and 3-month old. A brain-MRI showed no suspicious epileptogenic lesions. Total 24 hours of video-EEG monitoring revealed parietal dominant bilateral theta activity and diffuse high amplitude spike & wave burst, interictally. Bilateral myoclonic seizures with high amplitude spike or polyspike & wave were captured over 100 times during drowsiness and sleep. He was undergone anterior four fifth CC at 8-year and 5-month old. His myoclonic seizures decreased to a few times a month. We added vagus nerve stimulation (VNS) therapy for his residual seizures at 9-year and 1-month old. Interictal EEG did not show epileptiform discharges at 10-year and 6-month old. At the last follow up at 10-year and 10-month old, only simple partial seizures once a month remained.
Discussion: CC might be a valuable option for patients with medically refractory myoclonic seizures which are thought to be associated with interhemispheric interaction.