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--- total_corpus_callosotomy [2025/07/08 03:51] – [Case reports] administrador
+++ total_corpus_callosotomy [2025/07/08 03:52] (current) – administrador
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   * Requires careful **multidisciplinary evaluation**
   * Particularly valuable when **epileptogenic zone is not localizable**
-===== Case reports =====
-In a single-patient illustrative case.
-Mine et al.
-from the Kyushu University, Fukuoka, Japan.
-poblished in the [[Journal of Neurosurgery Case Lessons]],
-to report on the first adult case of [[Dentatorubral-pallidoluysian atrophy]] (DRPLA)-associated [[progressive myoclonic epilepsy]] (PME) undergoing [[total corpus callosotomy]] (CC) for [[refractory seizure]]s.
-Total CC led to a marked reduction in seizure frequency; tonic seizures and FBTCSs with desaturation resolved by 1 year, improving QOL
-((Mine D, Shimogawa T, Sakai Y, Shigeto H, Okubo S, Sakata A, Watanabe E, Nakamizo A, Yoshimoto K. [[Total corpus callosotomy]] for an adult patient with [[progressive myoclonic epilepsy]] associated with [[dentatorubral-pallidoluysian atrophy]]: illustrative case. J Neurosurg Case Lessons. 2025 Jul 7;10(1):CASE2576. doi: 10.3171/CASE2576. PMID: 40623331.)).
-===== Critical Appraisal =====
-  * **Strengths**:
-    – Novelty: First reported adult DRPLA-PME CC case.
-    – Clear epilepsy burden: Longstanding myoclonus, tonic seizures, status epilepticus with oxygen desaturation.
-    – Intervention and outcome: Rapid seizure control post-CC, with sustained benefit at 1-year follow-up.
-  * **Limitations**:
-    – Single case—limited generalizability.
-    – No control, no comparative analysis vs. anterior CC or other modalities.
-    – Cognitive trajectory not objectively quantified pre- vs. post-op.
-    – DRPLA is diffuse; CC addresses interhemispheric spread rather than epileptogenic focus.
-  * **Intellectual Rigour**:
-    – Authors correctly acknowledge palliative intent.
-    – Background supported by PME CC precedent in pediatric and non-DRPLA cohorts :contentReference[oaicite:1]{index=1}.
-    – However, literature discussion could further weigh alternative interventions (thalamic stimulation, VNS).
-  * **Clinical Verdict**:
-    – Verdict: **6/10** – Interesting and well-documented, but lacks broader context and rigorous outcome measures.
-===== Takeaway for Practicing Neurosurgeons =====
-  * For adult DRPLA patients with refractory PME and severe daily seizures, total CC can be a viable palliative option.
-  * Offers rapid seizure reduction and improved oxygenation and QOL without major additional harm.
-===== Bottom Line =====
-Total corpus callosotomy may be effective [[palliative]] therapy in adult-onset DRPLA-related PME when conventional treatments fail.
-===== Citation & Metadata =====
-  * **Title**: Total corpus callosotomy for an adult patient with progressive myoclonic epilepsy associated with dentatorubral-pallidoluysian atrophy: illustrative case
-  * **Full citation**: Mine D, et al. J Neurosurg Case Lessons. 2025 Jul 7;10(1):CASE2576. doi:10.3171/CASE2576.
-  * **Publication date**: July 7, 2025
-==== WordPress Categories ====
-Case Report, Epilepsy Surgery, DRPLA, Corpus Callosotomy
-==== Tags ====
-PME, DRPLA, callosotomy, adult epilepsy, palliative neurosurgery, case lessons