RESUMEN
The authors present the case of a 6-year-old girl with typical absence epilepsy induced by hyperventilation associated with moyamoya disease (MMD). A diffuse 3-Hz spike-and-wave complex induced by hyperventilation was apparent on an electroencephalogram, and her seizures were intractable to medication. Significant ischemia in the bilateral frontal lobes was present. The epilepsy disappeared after superficial temporal artery-middle cerebral artery anastomosis with encephalomyosynangiosis on both sides. In the treatment of children with intractable absence epilepsy, the possibility of underlying MMD and indications that revascularization surgery may be needed should be taken into consideration.
Asunto(s)
Electroencefalografía , Epilepsia Tipo Ausencia/diagnóstico , Enfermedad de Moyamoya/diagnóstico , Anticonvulsivantes/uso terapéutico , Aspirina/uso terapéutico , Arteria Carótida Interna/cirugía , Estenosis Carotídea/diagnóstico , Estenosis Carotídea/cirugía , Angiografía Cerebral , Infarto Cerebral/diagnóstico , Infarto Cerebral/cirugía , Revascularización Cerebral , Niño , Preescolar , Terapia Combinada , Resistencia a Medicamentos , Epilepsia Tipo Ausencia/cirugía , Femenino , Estudios de Seguimiento , Lóbulo Frontal/irrigación sanguínea , Humanos , Enfermedad de Moyamoya/cirugía , Complicaciones Posoperatorias/diagnóstico , Tomografía Computarizada de Emisión de Fotón Único , Ácido Valproico/uso terapéuticoRESUMEN
Stereotactic Forel-H-Tomy has been performed in 20 cases of epilepsy refractory to medication of which 15 have been followed from 2 to 7 years. The outcome of operation in 7 cases is judged as 'markedly effective' or 'effective'. In 3 cases the operation was ineffective. Effectiveness was greater in bilateral operation. Improvement of EEG was indicated by disappearance or marked reduction of spikes (or sharp waves) or spike and wave complex. Grand mal seizures alone or cases of minor seizure alone have responded more favorably than other clinical types. Six cases demonstrated improvement of personality and emotions.