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Volume 11
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10.3390/brainsci11070827
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Case 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
1,*,
Tohru Okanishi
1,
Toshiki Nozaki
2,
Naoki Ichikawa
2,
Kazuki Sakakura
2,
Mitsuyo Nishimura
3,
Takahiro Yonekawa
4,
Hideo Enoki
1 and
Ayataka Fujimoto
2
1
Department of Child Neurology, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan
2
Epilepsy and Surgery, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan
3
Division of Clinical Laboratory, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan
4
Department of Pediatrics, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
*
Author to whom correspondence should be addressed.
Brain Sci. 2021, 11(7), 827; https://doi.org/10.3390/brainsci11070827
Submission received: 30 May 2021 / Revised: 19 June 2021 / Accepted: 20 June 2021 / Published: 22 June 2021
(This article belongs to the Special Issue Corpus Callosotomy)
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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. 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.
Keywords: epileptic encephalopathy; encephalopathy with continuous spikes and waves during sleep (ECSWS); neonatal thalamic hemorrhage; intracranial electroencephalogram; hemispherotomy epileptic encephalopathy; encephalopathy with continuous spikes and waves during sleep (ECSWS); neonatal thalamic hemorrhage; intracranial electroencephalogram; hemispherotomy

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MDPI and ACS Style

Baba, S.; Okanishi, T.; Nozaki, T.; Ichikawa, N.; Sakakura, K.; Nishimura, M.; Yonekawa, T.; Enoki, H.; Fujimoto, A. 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. Brain Sci. 2021, 11, 827. https://doi.org/10.3390/brainsci11070827

AMA Style

Baba S, Okanishi T, Nozaki T, Ichikawa N, Sakakura K, Nishimura M, Yonekawa T, Enoki H, Fujimoto A. 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. Brain Sciences. 2021; 11(7):827. https://doi.org/10.3390/brainsci11070827

Chicago/Turabian Style

Baba, Shimpei, Tohru Okanishi, Toshiki Nozaki, Naoki Ichikawa, Kazuki Sakakura, Mitsuyo Nishimura, Takahiro Yonekawa, Hideo Enoki, and Ayataka Fujimoto. 2021. "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" Brain Sciences 11, no. 7: 827. https://doi.org/10.3390/brainsci11070827

APA Style

Baba, S., Okanishi, T., Nozaki, T., Ichikawa, N., Sakakura, K., Nishimura, M., Yonekawa, T., Enoki, H., & Fujimoto, A. (2021). 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. Brain Sciences, 11(7), 827. https://doi.org/10.3390/brainsci11070827

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