Lateralization of interictal spikes after corpus callosotomy

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12 Citations (Scopus)

Abstract

Objective: Corpus callosotomy may limit secondary bilateral synchrony into the primary epileptogenic hemisphere. This study investigated whether pre-operative EEG can predict post-operative spike lateralization. Methods: The subjects included 14 patients with medically intractable drop attacks who underwent total corpus callosotomy. Pre-operative patterns of inter-hemispheric propagation were quantified by peak-latency analysis with the template-based spike averaging technique. Results: Postoperative lateralization of interictal spikes was observed in 5 of the 14 patients. Inter-hemispheric latency was significantly longer in these 5 patients (mean 14.0. ms, range from 0 to 78. ms, versus mean 5.2. ms, range from 0 to 29 ms, p<0.01). The lateralization occurred in association with the presence of structural lesions (p<0.05). The post-operative spikes were lateralized to the lesion side in 3 of 4 patients with unilateral epileptogenic lesion. Three patients presented one-way inter-hemispheric propagation pattern pre-operatively. The post-operative spikes were lateralized to the hemisphere of the leading spikes in two. Conclusions: Interictal spikes are lateralized to the epileptogenic hemisphere in some patients after callosotomy. Lateralization can be expected in the presence of structural lesions and/or longer inter-hemispheric latency. Significance: Analysis of pre-operative EEG spikes may predict the primary epileptogenic hemisphere before corpus callosotomy.

Original languageEnglish
Pages (from-to)2121-2127
Number of pages7
JournalClinical Neurophysiology
Volume122
Issue number11
DOIs
Publication statusPublished - 2011 Nov 1

Keywords

  • Corpus callosum
  • Drop attacks
  • Epilepsy surgery
  • Generalized epilepsy
  • Interictal spikes

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Physiology (medical)
  • Sensory Systems

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