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Posterior quadrant disconnection for refractory epilepsy: how I do it

par Barrit, Sami ;Park, Eun Hyoung;Madsen, Joseph J.R.
Référence Acta neurochirurgica
Publication Publié, 2022

Article révisé par les pairs

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Résumé :

Background: Posterior quadrant disconnection (PQD) is intended to interrupt the propagation of intractable unilateral temporo-parieto-occipital epilepsy. Method: An enhanced operative video presents the illustrative case of a total PQD indicated for a 15-year-old boy with Sturge-Weber syndrome suffering from seizure recurrence after a partial PQD. We describe the surgical procedure with emphasis on relevant anatomy and multimodal intraoperative guidance in three steps: (i) parieto-occipital disconnection, (ii) posterior callosotomy, and (iii) temporal disconnection/resection. Pearls and pitfalls of surgical management are discussed. Conclusion: PQD is a less invasive surgical option to typical hemispherotomy and hemispherectomy for selected indications of posterior multilobar epilepsy.