Document Detail


Reversible acquired epileptic frontal syndrome and CSWS suppression in a child with congenital hemiparesis treated by hemispherotomy.
MedLine Citation:
PMID:  18945626     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A boy with a right congenital hemiparesis due to a left pre-natal middle cerebral artery infarct developed focal epilepsy at 33 months and then an insidious and subsequently more rapid, massive cognitive and behavioural regression with a frontal syndrome between the ages of 4 and 5 years with continuous spike-waves during sleep (CSWS) on the EEG. Both the epilepsy and the CSWS were immediately suppressed by hemispherotomy at the age of 5 years and 4 months. A behavioural-cognitive follow-up prior to hemispherotomy, an per-operative EEG and corticography and serial post-operative neuropsychological assessments were performed until the age of 11 years. The spread of the epileptic activity to the "healthy" frontal region was the cause of the reversible frontal syndrome. A later gradual long-term but incomplete cognitive recovery, with moderate mental disability was documented. This outcome is probably explained by another facet of the epilepsy, namely the structural effects of prolonged epileptic discharges in rapidly developing cerebral networks which are, at the same time undergoing the reorganization imposed by a unilateral early hemispheric lesion. Group studies on the outcome of children before and after hemispherectomy using only single IQ measures, pre- and post-operatively, may miss particular epileptic cognitive dysfunctions as they are likely to be different from case to case. Such detailed and rarely available complementary clinical and EEG data obtained in a single case at different time periods in relation to the epilepsy, including per-operative electrophysiological findings, may help to understand the different cognitive deficits and recovery profiles and the limits of full cognitive recovery.
Authors:
Christine Kallay; Claire Mayor-Dubois; Malin Maeder-Ingvar; Margritta Seeck; Damien Debatisse; Thierry Deonna; Eliane Roulet-Perez
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-10-22
Journal Detail:
Title:  European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society     Volume:  13     ISSN:  1532-2130     ISO Abbreviation:  Eur. J. Paediatr. Neurol.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-17     Completed Date:  2009-10-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9715169     Medline TA:  Eur J Paediatr Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  430-8     Citation Subset:  IM    
Affiliation:
Paediatric Neurology and Neurorehabilitation Unit, CHUV, Rue du Bugnon, BH 11, Lausanne, Switzerland. christine.kallay@chuv.ch
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MeSH Terms
Descriptor/Qualifier:
Attention / physiology
Child
Child Development
Child, Preschool
Electroencephalography*
Electrophysiology
Emotions / physiology
Epilepsy, Frontal Lobe / etiology,  surgery,  therapy*
Humans
Infarction, Middle Cerebral Artery / complications,  congenital
Magnetic Resonance Imaging
Male
Neurologic Examination
Neuropsychological Tests
Neurosurgical Procedures*
Paresis / complications,  congenital*,  surgery*
Seizures / physiopathology
Sleep Disorders / etiology,  pathology,  therapy*
Social Behavior
Time Perception
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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