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Vertical parasagittal hemispherotomy: a case report of postoperative mesio-temporal seizures via amygdalofugal pathway

  • Case Report - Functional Neurosurgery - Epilepsy
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Abstract

Vertical parasagittal hemispherotomy (VPH) is a well-established surgical treatment which is proposed for children with widespread unilateral onset of intractable epileptic seizures. VPH allows to disconnect from a vertical transventricular approach all white matter fibers of the hemisphere around a central core including the thalamus. We present the case of a girl who underwent VPH for hemimegalencephaly in early infancy. Postoperatively, she developed unexpected seizures of mesio-temporal origin. Stereo-EEG provided arguments for an amygdalar origin. High-resolution MRI with tractography confirmed the presence of the amygdalo-fugal pathway to be responsible of epileptic discharges propagation. She became seizure-free after temporal resection.

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References

  1. Bartoli A, El Hassani Y, Jenny B, Momjian S, Korff CM, Seeck M, Vulliemoz S, Schaller K (2018) What to do in failed hemispherotomy? Our clinical series and review of the literature. Neurosurg Rev 41(1):125–132

    Article  Google Scholar 

  2. Delalande O, Bulteau C, Dellatolas G, Fohlen M, Jalin C, Buret V, Viguier D, Dorfmüller G, Jambaqué I (2007) Vertical parasagittal hemispherotomy: surgical procedures and clinical long-term outcomes in a population of 83 children. Neurosurgery 60(2 Suppl 1):ONS19–ONS32 discussion ONS32

    PubMed  Google Scholar 

  3. Delalande O, Dorfmüller G (2008) Parasagittal vertical hemispherotomy: surgical procedure. Neurochirurgie 54(3):353–357

    Article  CAS  Google Scholar 

  4. Delalande O, Pinard J, Basdevant C, Gauthe M, Plouin P, Dulac O (1992) Hemispherotomy: a new procedure for central disconnection. Epilepsia

  5. Dorfer C, Czech T, Dressler A, Gröppel G, Mühlebner-Fahrngruber A, Novak K, Reinprecht A, Reiter-Fink E, Traub-Weidinger T, Feucht M (2013) Vertical perithalamic hemispherotomy: a single-center experience in 40 pediatric patients with epilepsy. Epilepsia 54(11):1905–1912

    Article  Google Scholar 

  6. Dorfer C, Khalaveh F, Dorfmüller G, Czech T (2019) Surgical anatomy of vertical perithalamic hemispherotomy. Oper Neurosurg (Hagerstown). https://doi.org/10.1093/ons/opz214

  7. González-Martínez JA, Gupta A, Kotagal P, Lachhwani D, Wyllie E, Lüders HO, Bingaman WE (2005) Hemispherectomy for catastrophic epilepsy in infants. Epilepsia 46(9):1518–1525

    Article  Google Scholar 

  8. Kamali A, Sair HI, Blitz AM, Riascos RF, Mirbagheri S, Keser Z, Hasan KM (2016) Revealing the ventral amygdalofugal pathway of the human limbic system using high spatial resolution diffusion tensor tractography. Brain Struct Funct 221(7):3561–3569

    Article  Google Scholar 

  9. Kiehna EN, Widjaja E, Holowka S et al (2016) Utility of diffusion tensor imaging studies linked to neuronavigation and other modalities in repeat hemispherotomy for intractable epilepsy. J Neurosurg Pediatr 17(4):483–490

    Article  Google Scholar 

  10. Krüger O, Shiozawa T, Kreifelts B, Scheffler K, Ethofer T (2015) Three distinct fiber pathways of the bed nucleus of the stria terminalis to the amygdala and prefrontal cortex. Cortex 66:60–68

    Article  Google Scholar 

  11. Li M, Ribas EC, Wei P, Li M, Zhang H, Guo Q (1746) The ansa peduncularis in the human brain: a tractography and fiber dissection study. Brain Res 2020:146978

  12. Mori S, Kageyama Y, Hou Z, Aggarwal M, Patel J, Brown T, Miller MI, Wu D, Troncoso JC (2017) Elucidation of white matter tracts of the human amygdala by detailed comparison between high-resolution postmortem magnetic resonance imaging and histology. Front Neuroanat 11:16

    Article  Google Scholar 

  13. Peltier J, Verclytte S, Delmaire C, Pruvo J-P, Havet E, Le Gars D (2011) Microsurgical anatomy of the anterior commissure: correlations with diffusion tensor imaging fiber tracking and clinical relevance. Open Neurosurg (Hagerstown) 69(suppl_2):ons241–ons247

    Google Scholar 

  14. Türe U, Yaşargil MG, Friedman AH, Al-Mefty O (2000) Fiber dissection technique: lateral aspect of the brain. Neurosurgery 47(2):417–426 discussion 426-427

    Article  Google Scholar 

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Acknowledgements

We wish to thank Ms. Rukmani Bhan for her participation in proofreading and translating our case report.

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Authors and Affiliations

  1. Pediatric Neurosurgery Department, Rothschild Foundation Hospital, Paris, France

    Mathieu Helleringer, Georg Dorfmüller, Sarah Ferrand-Sorbets, Delphine Taussig, Jerry Blustjan, Olivier Delalande, Sarah Rosenberg, Anne de Saint Martin, Pierre Bourdillon & Christine Bulteau

  2. Department of Neurosurgery, CHRU Nancy, Nancy, France

    Mathieu Helleringer

  3. Radiology Department, Rothschild Foundation Hospital, Paris, France

    Jerry Blustjan

  4. Pediatric Neurology Department, CHU Haute-Pierre, Strasbourg, France

    Anne de Saint Martin

  5. MC2Lab, Institute of Psychology, University of Paris, F-92100, Boulogne-Billancourt, France

    Christine Bulteau

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  1. Mathieu Helleringer
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  2. Georg Dorfmüller
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  3. Sarah Ferrand-Sorbets
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  4. Delphine Taussig
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  5. Jerry Blustjan
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  6. Olivier Delalande
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  7. Sarah Rosenberg
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  8. Anne de Saint Martin
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  9. Pierre Bourdillon
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  10. Christine Bulteau
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Correspondence to Christine Bulteau.

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This article is part of the Topical Collection on Functional Neurosurgery – Epilepsy

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Helleringer, M., Dorfmüller, G., Ferrand-Sorbets, S. et al. Vertical parasagittal hemispherotomy: a case report of postoperative mesio-temporal seizures via amygdalofugal pathway. Acta Neurochir 163, 2833–2836 (2021). https://doi.org/10.1007/s00701-021-04836-w

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  • DOI: https://doi.org/10.1007/s00701-021-04836-w

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