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Successful Hemispherotomy in a Patient with Encephalopathy with Continuous Spikes and Waves during Sleep Related to Neonatal Thalamic Hemorrhage: A Case Report with Intracranial Electroencephalogram Findings

Neonatal thalamic hemorrhage is a strong risk factor for developing encephalopathy with continuous spikes and waves during sleep (ECSWS), even when not accompanied by widespread cortical destruction. The efficacy and indication of resective epilepsy surgery in such patients has not yet been reported...

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Autores principales: Baba, Shimpei, Okanishi, Tohru, Nozaki, Toshiki, Ichikawa, Naoki, Sakakura, Kazuki, Nishimura, Mitsuyo, Yonekawa, Takahiro, Enoki, Hideo, Fujimoto, Ayataka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301857/
https://www.ncbi.nlm.nih.gov/pubmed/34206592
http://dx.doi.org/10.3390/brainsci11070827
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author Baba, Shimpei
Okanishi, Tohru
Nozaki, Toshiki
Ichikawa, Naoki
Sakakura, Kazuki
Nishimura, Mitsuyo
Yonekawa, Takahiro
Enoki, Hideo
Fujimoto, Ayataka
author_facet Baba, Shimpei
Okanishi, Tohru
Nozaki, Toshiki
Ichikawa, Naoki
Sakakura, Kazuki
Nishimura, Mitsuyo
Yonekawa, Takahiro
Enoki, Hideo
Fujimoto, Ayataka
author_sort Baba, Shimpei
collection PubMed
description Neonatal thalamic hemorrhage is a strong risk factor for developing encephalopathy with continuous spikes and waves during sleep (ECSWS), even when not accompanied by widespread cortical destruction. The efficacy and indication of resective epilepsy surgery in such patients has not yet been reported. A 4-year-old boy was diagnosed with ECSWS based on strong epileptiform activation during sleep and neurocognitive deterioration. He had a history of left thalamic hemorrhage related to a straight sinus thrombosis during the newborn period. He presented with daily absence seizures that were refractory to medical treatment. At age 5, he underwent intracranial electroencephalogram (EEG) recording using depth and subdural strip electrodes placed in the left thalamus and over bilateral cortex, respectively. Interictal and ictal epileptiform discharges were observed in the thalamus, always preceded by discharges in the left or right parietal lobe. Left hemispherotomy successfully normalized the EEG of his unaffected hemisphere and extinguished his seizures. This is the first case report documenting resective epilepsy surgery in a patient with ECSWS due to neonatal thalamic injury without widespread cerebral destruction. Based on intracranial EEG findings, his injured thalamus did not directly generate the EEG abnormalities or absence seizures on its own. Patients with ipsilateral neonatal thalamic injury and even mild lateralized cortical changes may be candidates for resective or disconnective surgery for ECSWS.
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spelling pubmed-83018572021-07-24 Successful Hemispherotomy in a Patient with Encephalopathy with Continuous Spikes and Waves during Sleep Related to Neonatal Thalamic Hemorrhage: A Case Report with Intracranial Electroencephalogram Findings Baba, Shimpei Okanishi, Tohru Nozaki, Toshiki Ichikawa, Naoki Sakakura, Kazuki Nishimura, Mitsuyo Yonekawa, Takahiro Enoki, Hideo Fujimoto, Ayataka Brain Sci Case Report Neonatal thalamic hemorrhage is a strong risk factor for developing encephalopathy with continuous spikes and waves during sleep (ECSWS), even when not accompanied by widespread cortical destruction. The efficacy and indication of resective epilepsy surgery in such patients has not yet been reported. A 4-year-old boy was diagnosed with ECSWS based on strong epileptiform activation during sleep and neurocognitive deterioration. He had a history of left thalamic hemorrhage related to a straight sinus thrombosis during the newborn period. He presented with daily absence seizures that were refractory to medical treatment. At age 5, he underwent intracranial electroencephalogram (EEG) recording using depth and subdural strip electrodes placed in the left thalamus and over bilateral cortex, respectively. Interictal and ictal epileptiform discharges were observed in the thalamus, always preceded by discharges in the left or right parietal lobe. Left hemispherotomy successfully normalized the EEG of his unaffected hemisphere and extinguished his seizures. This is the first case report documenting resective epilepsy surgery in a patient with ECSWS due to neonatal thalamic injury without widespread cerebral destruction. Based on intracranial EEG findings, his injured thalamus did not directly generate the EEG abnormalities or absence seizures on its own. Patients with ipsilateral neonatal thalamic injury and even mild lateralized cortical changes may be candidates for resective or disconnective surgery for ECSWS. MDPI 2021-06-22 /pmc/articles/PMC8301857/ /pubmed/34206592 http://dx.doi.org/10.3390/brainsci11070827 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Baba, Shimpei
Okanishi, Tohru
Nozaki, Toshiki
Ichikawa, Naoki
Sakakura, Kazuki
Nishimura, Mitsuyo
Yonekawa, Takahiro
Enoki, Hideo
Fujimoto, Ayataka
Successful Hemispherotomy in a Patient with Encephalopathy with Continuous Spikes and Waves during Sleep Related to Neonatal Thalamic Hemorrhage: A Case Report with Intracranial Electroencephalogram Findings
title Successful Hemispherotomy in a Patient with Encephalopathy with Continuous Spikes and Waves during Sleep Related to Neonatal Thalamic Hemorrhage: A Case Report with Intracranial Electroencephalogram Findings
title_full Successful Hemispherotomy in a Patient with Encephalopathy with Continuous Spikes and Waves during Sleep Related to Neonatal Thalamic Hemorrhage: A Case Report with Intracranial Electroencephalogram Findings
title_fullStr Successful Hemispherotomy in a Patient with Encephalopathy with Continuous Spikes and Waves during Sleep Related to Neonatal Thalamic Hemorrhage: A Case Report with Intracranial Electroencephalogram Findings
title_full_unstemmed Successful Hemispherotomy in a Patient with Encephalopathy with Continuous Spikes and Waves during Sleep Related to Neonatal Thalamic Hemorrhage: A Case Report with Intracranial Electroencephalogram Findings
title_short Successful Hemispherotomy in a Patient with Encephalopathy with Continuous Spikes and Waves during Sleep Related to Neonatal Thalamic Hemorrhage: A Case Report with Intracranial Electroencephalogram Findings
title_sort successful hemispherotomy in a patient with encephalopathy with continuous spikes and waves during sleep related to neonatal thalamic hemorrhage: a case report with intracranial electroencephalogram findings
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301857/
https://www.ncbi.nlm.nih.gov/pubmed/34206592
http://dx.doi.org/10.3390/brainsci11070827
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