Endoscope-assisted posterior quadrant disconnection plus corpus callosotomy: case report

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  • 1 Department of Neurosurgery, Division of Pediatric Neurosurgery, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas; and
  • 2 Department of Neurosurgery, Division of Pediatric Neurosurgery, Northwestern University, Lurie Children’s Hospital, Chicago, Illinois
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Intractable epilepsy impacts many children. Surgically resective and palliative treatments have developed to increase seizure freedom or palliate the seizure burden in those with medically refractory epilepsy. However, surgical epilepsy treatment can confer significant morbidity and death. Endoscope-assisted surgical approaches may be helpful in reducing the morbidity related to traditional open surgical approaches while allowing for good visualization of surgical targets. Here, the authors report a case utilizing an endoscope-assisted keyhole approach to perform a posterior quadrantectomy and corpus callosotomy, achieving the surgical goals of disconnection and reducing the need for large craniotomy exposure. They present the case of a 17-year-old male with medically refractory epilepsy treated with endoscope-assisted posterior quadrantectomy and corpus callosotomy through two mini-craniotomies to achieve a functional disconnection. To the authors’ knowledge, this is the first reported case of an endoscope-assisted approach for a posterior quadrantectomy for surgical epilepsy treatment in an adult or a pediatric patient. The case is reported to highlight the technical nuances and benefits of this approach in select patients as well as the expansion of applications of endoscope-assisted epilepsy surgery.

ABBREVIATIONS AED = antiepileptic drug; CSF = cerebrospinal fluid; EVD = external ventricular drain; MTG = middle temporal gyrus; POD = postoperative day; VNS = vagus nerve stimulation.

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Contributor Notes

Correspondence Sandi Lam: Lurie Children’s Hospital, Chicago, IL. sandilam@gmail.com; slam@luriechildrens.org.

INCLUDE WHEN CITING Published online January 15, 2021; DOI: 10.3171/2020.8.PEDS20432.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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