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Editorial

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3 pages, 184 KiB

Open AccessEditorial

Corpus Callosotomy: Editorial

by Ayataka Fujimoto and Tohru Okanishi

Brain Sci. 2022, 12(8), 1006; https://doi.org/10.3390/brainsci12081006 - 29 Jul 2022

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Abstract

Since corpus callosotomy (CC) was first reported in 1940 [...] Full article

(This article belongs to the Special Issue Corpus Callosotomy)

Research

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8 pages, 1300 KiB

Open AccessCommunication

The Fornix May Play a Key Role in Korsakoff’s Amnesia Secondary to Subcallosal Artery Infarction

by Masataka Hayashi, Ayataka Fujimoto, Hideo Enoki, Keiko Niimi, Chikanori Inenaga, Keishiro Sato, Kazunari Homma, Tomoya Arakawa and Tohru Okanishi

Brain Sci. 2022, 12(1), 21; https://doi.org/10.3390/brainsci12010021 - 24 Dec 2021

Cited by 2 | Viewed by 2480

Abstract

Background: Subcallosal artery infarction injures the fornix and anterior corpus callosum and sometimes causes Korsakoff’s amnesia. We hypothesized that Korsakoff’s amnesia might be caused by fornix dysfunction rather than anterior corpus callosum dysfunction in subcallosal artery infarction. Methods: A systematic review approach was [...] Read more.

Background: Subcallosal artery infarction injures the fornix and anterior corpus callosum and sometimes causes Korsakoff’s amnesia. We hypothesized that Korsakoff’s amnesia might be caused by fornix dysfunction rather than anterior corpus callosum dysfunction in subcallosal artery infarction. Methods: A systematic review approach was applied to search PubMed and Google Scholar for articles to compare patients who had both bilateral fornix and corpus callosum infarction due to subcallosal artery territory ischemia (vascular event group; V group) with patients who had undergone anterior corpus callosotomy (callosotomy group; C group). Results: The V group comprised 10 patients (mean age, 63 years; median, 69 years; standard deviation (SD), 14.5 years; 5 males, 5 females). The C group comprised 6 patients (mean age, 23.7 years; median, 20 years; SD, 7.3 years; 3 males, 3 females). Six of 10 patients (60%) with subcallosal artery infarction exhibited Korsakoff’s amnesia. One patient showed neither confabulation nor amnesia. Conversely, no amnesia episodes were seen in any patients from the C group (p = 0.034). Conclusion: Fornix injury, rather than anterior corpus callosum injury, might be the major cause of Korsakoff’s amnesia in patients with subcallosal artery infarction. Full article

(This article belongs to the Special Issue Corpus Callosotomy)

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10 pages, 942 KiB

Open AccessArticle

Effects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant Epilepsy

by Keisuke Hatano, Ayataka Fujimoto, Takamichi Yamamoto, Hideo Enoki and Tohru Okanishi

Brain Sci. 2021, 11(11), 1395; https://doi.org/10.3390/brainsci11111395 - 23 Oct 2021

Cited by 1 | Viewed by 1635

Abstract

Objective: The effectiveness of vagus nerve stimulation (VNS) for residual seizures after corpus callosotomy (CC) has not yet been fully investigated. We hypothesized that seizure control would be improved by VNS after CC. The purpose of this study was to compare seizure frequency [...] Read more.

Objective: The effectiveness of vagus nerve stimulation (VNS) for residual seizures after corpus callosotomy (CC) has not yet been fully investigated. We hypothesized that seizure control would be improved by VNS after CC. The purpose of this study was to compare seizure frequency between patients with implantation of a VNS generator (post-VNS group) or without VNS (non-post-VNS group) following CC. Methods: We retrospectively reviewed patients who underwent CC between January 2009 and May 2019 in our institution. We evaluated proportions of ≥50% reduction in seizure frequency (responders) and seizure reduction rate 1 and 2 years after VNS. To investigate factors related to responders, uni- and multivariate logistic regression analyses were performed regarding age, number of anti-seizure medications (ASMs), addition of novel ASMs (levetiracetam, lacosamide or perampanel), and post-VNS or non-post-VNS status. Results: Thirteen post-VNS patients and 24 non-post-VNS patients were analyzed in this study. Responder rate at 1 year after VNS differed significantly between the post-VNS group (53.9%) and non-post-VNS group (12.5%, p = 0.017). Number of ASMs at the time of CC and post-VNS were significantly associated with responders in univariate analyses (odds ratio [OR] 0.34, 95% confidence interval [CI] 0.13–0.88, p = 0.025 and OR 8.2, 95%CI 1.6–41.6, p = 0.011, respectively), whereas age, sex, seizure frequency, and addition of novel ASMs were not. In multivariate analysis, the presence of VNS procedures after CC was the only factor favorably associated with responder status (OR 82.2, 95%CI 1.55–4355.7, p = 0.03). Conclusions: VNS therapy after CC may increase the proportion of responders independent of the addition of novel ASMs. Full article

(This article belongs to the Special Issue Corpus Callosotomy)

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Review

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8 pages, 2824 KiB

Open AccessReview

Surgical Aspects of Corpus Callosotomy

by Takehiro Uda, Noritsugu Kunihiro, Ryoko Umaba, Saya Koh, Toshiyuki Kawashima, Shohei Ikeda, Kotaro Ishimoto and Takeo Goto

Brain Sci. 2021, 11(12), 1608; https://doi.org/10.3390/brainsci11121608 - 5 Dec 2021

Cited by 13 | Viewed by 6124

Abstract

Corpus callosotomy (CC) is one of the options in epilepsy surgeries to palliate patient seizures, and is typically applied for drop attacks. The mechanisms of seizure palliation involve disrupting the propagation of epileptic activity to the contralateral side of the brain. This review [...] Read more.

Corpus callosotomy (CC) is one of the options in epilepsy surgeries to palliate patient seizures, and is typically applied for drop attacks. The mechanisms of seizure palliation involve disrupting the propagation of epileptic activity to the contralateral side of the brain. This review article focuses on the surgical aspects of CC. As a variations of CC, anterior two-thirds, posterior one-third, and total callosotomy are described with intraoperative photographs. As less-invasive surgical variations, recent progress in endoscopic CC, and CC without craniotomy, is described. CC remains acceptable under the low prevalence of complications, and surgeons should make the maximum effort to minimize the complication rate. Full article

(This article belongs to the Special Issue Corpus Callosotomy)

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15 pages, 2157 KiB

Open AccessReview

Corpus Callosotomy for Controlling Epileptic Spasms: A Proposal for Surgical Selection

by Tohru Okanishi and Ayataka Fujimoto

Brain Sci. 2021, 11(12), 1601; https://doi.org/10.3390/brainsci11121601 - 1 Dec 2021

Cited by 6 | Viewed by 4206

Abstract

In 1940, van Wagenen and Herren first proposed the corpus callosotomy (CC) as a surgical procedure for epilepsy. CC has been mainly used to treat drop attacks, which are classified as generalized tonic or atonic seizures. Epileptic spasms (ESs) are a type of [...] Read more.

In 1940, van Wagenen and Herren first proposed the corpus callosotomy (CC) as a surgical procedure for epilepsy. CC has been mainly used to treat drop attacks, which are classified as generalized tonic or atonic seizures. Epileptic spasms (ESs) are a type of epileptic seizure characterized as brief muscle contractions with ictal polyphasic slow waves on an electroencephalogram and a main feature of West syndrome. Resection surgeries, including frontal/posterior disconnections and hemispherotomy, have been established for the treatment of medically intractable ES in patients with unilaterally localized epileptogenic regions. However, CC has also been adopted for ES treatment, with studies involving CC to treat ES having increased since 2010. In those studies, patients without lesions observed on magnetic resonance imaging or equally bilateral lesions predominated, in contrast to studies on resection surgeries. Here, we present a review of relevant literature concerning CC and relevant adaptations. We discuss history and adaptations of CC, and patient selection for epilepsy surgeries due to medically intractable ES, and compared resection surgeries with CC. We propose a surgical selection flow involving resection surgery or CC as first-line treatment for patients with ES who have been assessed as suitable candidates for surgery. Full article

(This article belongs to the Special Issue Corpus Callosotomy)

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Other

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13 pages, 4168 KiB

Open AccessCase Report

Corpus Callosotomy in 3 Cavalier King Charles Spaniel Dogs with Drug-Resistant Epilepsy

by Rikako Asada, Satoshi Mizuno, Yoshihiko Yu, Yuji Hamamoto, Tetsuya Anazawa, Daisuke Ito, Masato Kitagawa and Daisuke Hasegawa

Brain Sci. 2021, 11(11), 1462; https://doi.org/10.3390/brainsci11111462 - 4 Nov 2021

Cited by 9 | Viewed by 2706

Abstract

Corpus callosotomy (CC) is an established palliative surgery for human patients with drug-resistant epilepsy (DRE), especially those with generalized seizures and multiple or unknown epileptogenic focus. However, there are no reports to describe CC in canine patients with epilepsy. Three client-owned Cavalier King [...] Read more.

Corpus callosotomy (CC) is an established palliative surgery for human patients with drug-resistant epilepsy (DRE), especially those with generalized seizures and multiple or unknown epileptogenic focus. However, there are no reports to describe CC in canine patients with epilepsy. Three client-owned Cavalier King Charles Spaniels with DRE are included in this case series. In presurgical evaluations, an apparent epileptogenic zone was not detected in each dog and CC was conducted. Total CC was performed in one dog, whereas the other two received partial CC. One dog recovered from surgery without any complications, but died suddenly by an unknown cause at 10 h after surgery. For the other two dogs, postoperative evaluations including seizure outcomes, complications, and quality of life of the dogs and owners were assessed for at least 12 months. Both dogs showed a remarkable decrease in seizure frequency (averaged 80.3% reduction) and severity after surgery. The antiseizure medications were maintained, and not only the mentation and activity of the dogs, but also the quality of life of dogs and owners were improved postoperatively. Although technical improvement and more large-scale studies are needed, CC is a treatment option for dogs with DRE in veterinary medicine. Full article

(This article belongs to the Special Issue Corpus Callosotomy)

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Graphical abstract

9 pages, 2876 KiB

Open AccessCase Report

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

by Shimpei Baba, Tohru Okanishi, Toshiki Nozaki, Naoki Ichikawa, Kazuki Sakakura, Mitsuyo Nishimura, Takahiro Yonekawa, Hideo Enoki and Ayataka Fujimoto

Brain Sci. 2021, 11(7), 827; https://doi.org/10.3390/brainsci11070827 - 22 Jun 2021

Cited by 3 | Viewed by 2211

Abstract

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. [...] Read more.

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. Full article

(This article belongs to the Special Issue Corpus Callosotomy)

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7 pages, 572 KiB

Open AccessBrief Report

Postoperative Pneumocephalus on Computed Tomography Might Predict Post-Corpus Callosotomy Chemical Meningitis

by Ayataka Fujimoto, Keisuke Hatano, Toshiki Nozaki, Keishiro Sato, Hideo Enoki and Tohru Okanishi

Brain Sci. 2021, 11(5), 638; https://doi.org/10.3390/brainsci11050638 - 15 May 2021

Cited by 2 | Viewed by 1826

Abstract

Background: A corpus callosotomy (CC) is a procedure in which the corpus callosum, the largest collection of commissural fibers in the brain, is disconnected to treat epileptic seizures. The occurrence of chemical meningitis has been reported in association with this procedure. We hypothesized [...] Read more.

Background: A corpus callosotomy (CC) is a procedure in which the corpus callosum, the largest collection of commissural fibers in the brain, is disconnected to treat epileptic seizures. The occurrence of chemical meningitis has been reported in association with this procedure. We hypothesized that intraventricular pneumocephalus after CC surgery represents a risk factor for postoperative chemical meningitis. The purpose of this study was to analyze the potential risk factors for postoperative chemical meningitis in patients with medically intractable epilepsy who underwent a CC. Methods: Among the patients who underwent an anterior/total CC for medically intractable epilepsy between January 2009 and March 2021, participants were comprised of those who underwent a computed tomography scan on postoperative day 0. We statistically compared the groups with (c-Group) or without chemical meningitis (nc-Group) to determine the risk factors. Results: Of the 80 patients who underwent a CC, 65 patients (25 females and 40 males) met the inclusion criteria. Their age at the time of their CC procedure was 0–57 years. The c-Group (17%) was comprised of seven females and four males (age at the time of their CC procedure, 1–43 years), and the nc-Group (83%) was comprised of 18 females and 36 males (age at the time of their CC procedure, 0–57 years). Mann–Whitney U-tests (p = 0.002) and univariate logistic regression analysis (p = 0.001) showed a significant difference in pneumocephalus between the groups. Conclusion: Postoperative pneumocephalus identified on a computed tomography scan is a risk factor for post-CC chemical meningitis. Full article

(This article belongs to the Special Issue Corpus Callosotomy)

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