Endoscope-assisted corpus callosotomy for drug-resistant epilepsy in Moyamoya disease after revascularization surgery: A case report

Brain and Development Case Reports Pub Date : 2025-06-06 DOI:10.1016/j.bdcasr.2025.100086

Maki Narui , Noritsugu Kunihiro , Takehiro Uda , Ryoko Umaba , Ichiro Kuki , Akane Shikata , Keisuke Oki , Shin Okazaki , Hiroaki Sakamoto

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Abstract

Background

Approximately 20 % of patients with Moyamoya disease develop drug-resistant epilepsy; however, the unusual hemodynamics following revascularization surgery increase the complexity of surgical interventions.

Case

We report a case of a 9-year-old girl with Moyamoya disease who underwent revascularization surgery at the age of 2 and subsequently developed drug-resistant epilepsy characterized by focal-to-atonic seizures and startle seizures that resulted in traumatic injury. After thorough preoperative evaluations of both intracranial and extracranial hemodynamics, a safe craniotomy entry site was identified in the high frontal region. Corpus callosotomy was achieved via a small craniotomy with neuroendoscopic assistance. Postoperatively, the frequency of startle seizures decreased to levels that no longer caused trauma, and the focal-to-atonic seizures were reduced by more than 50 %.

Conclusion

Corpus callosotomy via a small craniotomy may be an effective treatment option for drug-resistant epilepsy associated with Moyamoya disease.

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内窥镜辅助胼胝体切开术治疗烟雾病血运重建术后耐药癫痫1例报告

大约20%的烟雾病患者发展为耐药癫痫；然而，血运重建术后不寻常的血流动力学增加了手术干预的复杂性。我们报告了一例患有烟雾病的9岁女孩，她在2岁时接受了血运重建手术，随后发展为以局灶到神经张力发作和惊吓发作为特征的耐药癫痫，导致创伤性损伤。在对颅内和颅外血流动力学进行全面的术前评估后，在高额区确定了一个安全的开颅切入点。胼胝体切开术是在神经内窥镜辅助下通过小开颅实现的。手术后，惊吓发作的频率降低到不再造成创伤的水平，病灶到神经张力发作减少了50%以上。结论小开颅胼胝体切开术可能是治疗耐药癫痫伴烟雾病的有效方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Brain and Development Case Reports

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