Corpus callosotomy in a patient with startle epilepsy
Nicolás Garófalo Gómez1, Ana Paula Hamad, Murilo Marinho
1Neuropediatric Department, Cuban Institute of Neurology and Neurosurgery, Havana, Cuba. nicogaro72@gmail.com
Summary
Startle epilepsy, characterized by reflex seizures triggered by stimuli, can be refractory to medication. Corpus callosotomy offers a potential surgical solution for severe, intractable cases.
Area of Science:
- Neurology
- Epileptology
Background:
- Startle epilepsy is a rare reflex epilepsy syndrome triggered by sudden stimuli.
- This case involves a pediatric patient with drug-refractory startle-induced seizures.
Observation:
- The patient experienced daily tonic seizures, leading to frequent falls and morbidity.
- EEG revealed central and fronto-central abnormalities, with generalized tonic posturing during seizures.
- MRI showed no structural abnormalities.
Findings:
- Video-polygraphic recordings demonstrated a characteristic ictal EEG pattern.
- Corpus callosotomy at age 17 resulted in complete seizure freedom at one-year follow-up.
Implications:
- Corpus callosotomy is a viable treatment option for severe startle epilepsy with tonic seizures.
- This surgical intervention may be considered when focal lesions are absent and epilepsy is intractable.
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