Turkish Neurosurgery 2014 , Vol 24 , Num 1
Anterior Corpus Callosotomy Combined with Anterior Temporal Resection with Amygdalohippocampectomy: Outcome in a Patient with Congenital Bilateral Perisylvian Syndrome
Zhu JUNMING1, Zhao YUANYUAN2, Feng FANG1, Fu WEIMING1, Hays RYAN3, Zhang JIANMIN1, Feng LI2, Jin XIAO2, Chen SHUDA2
1The Second Affiliated Hospital, Zhejiang University College of Medicine, Department of Neurosurgery, Hangzhou, China
2Zhejiang Provincial People’s Hospital, Department of Neurosurgery, Hangzhou, China
3UT Southwestern Medical Center, Department of Neurology and Neurotherapeutics, Dallas, USA
DOI : 10.5137/1019-5149.JTN.6362-12.1 Congenital bilateral perisylvian syndrome (CBPS) is characterized by epilepsy, cognitive deficits, pseudobulbar palsy and diplegia of the facial, pharyngeal and masticatory muscles. Epilepsy has been described in nearly 90% of affected patients. The epilepsy is usually severe and pharmacoresistant in about 55 percent of CBPS patients. Until now, only 12 cases of surgical treatment on CBPS have been reported; the surgical treatment is usually corpus callosotomy. In this paper, we describe a previously unreported combination of anterior corpus callosotomy plus anterior temporal lobectomy with amygdalohippocampectomy for a patient with CBPS, resulting in a satisfactory clinical outcome. Based on this case, we suggest that palliative focal resective surgery combined with anterior corpus callosotomy should be considered when a predominance of the epileptiform discharges suggests focal onset in patients with CBPS. Meanwhile, the clinical decision to adopt this combination surgery must be based on a thorough pre-surgical evaluation, and should take into account the clinical, radiological, and EEG features. Keywords : Congenital bilateral perisylvian syndrome (CBPS), Anterior corpus callosotomy, Anterior temporal resection, Epilepsy, Amygdalohippocampectomy
Corresponding author : Chen Shuda, chenshuda@sina.cn