{"title":"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","authors":"Maki Narui , Noritsugu Kunihiro , Takehiro Uda , Ryoko Umaba , Ichiro Kuki , Akane Shikata , Keisuke Oki , Shin Okazaki , Hiroaki Sakamoto","doi":"10.1016/j.bdcasr.2025.100086","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Approximately 20 % of patients with Moyamoya disease develop drug-resistant epilepsy; however, the unusual hemodynamics following revascularization surgery increase the complexity of surgical interventions.</div></div><div><h3>Case</h3><div>We report a case of <strong>a</strong> 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 %.</div></div><div><h3>Conclusion</h3><div>Corpus callosotomy via a small craniotomy may be an effective treatment option for drug-resistant epilepsy associated with Moyamoya disease.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 3","pages":"Article 100086"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Endoscope-assisted corpus callosotomy for drug-resistant epilepsy in Moyamoya disease after revascularization surgery: A case report\",\"authors\":\"Maki Narui , Noritsugu Kunihiro , Takehiro Uda , Ryoko Umaba , Ichiro Kuki , Akane Shikata , Keisuke Oki , Shin Okazaki , Hiroaki Sakamoto\",\"doi\":\"10.1016/j.bdcasr.2025.100086\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Approximately 20 % of patients with Moyamoya disease develop drug-resistant epilepsy; however, the unusual hemodynamics following revascularization surgery increase the complexity of surgical interventions.</div></div><div><h3>Case</h3><div>We report a case of <strong>a</strong> 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 %.</div></div><div><h3>Conclusion</h3><div>Corpus callosotomy via a small craniotomy may be an effective treatment option for drug-resistant epilepsy associated with Moyamoya disease.</div></div>\",\"PeriodicalId\":100196,\"journal\":{\"name\":\"Brain and Development Case Reports\",\"volume\":\"3 3\",\"pages\":\"Article 100086\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brain and Development Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S295022172500025X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain and Development Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S295022172500025X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Endoscope-assisted corpus callosotomy for drug-resistant epilepsy in Moyamoya disease after revascularization surgery: A case report
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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