PMC8264546_01
Scalp EEG. Preoperative scalp EEG revealed interictal epileptic discharges originating from the right hemisphere (A). Postoperative scalp EEG demonstrated that the interictal epileptic discharges from the right hemisphere were reduced (B).
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Prolonged scalp video interictal EEG showed that multifocal epileptiform abnormalities were generated only over the right hemisphere (Figure 1A). Both frequency and amplitude during interictal and ictal epileptic discharges have decreased (Figure 1B).
Preoperative imaging. Preoperative axial fluid-attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) demonstrated corpus callosum agenesis (arrow head) and bilateral (right dominant) ventricular dilatation (arrow) (A). Fluorodeoxyglucose-positron emission tomography-computed tomography showed hypometabolism in the right hemisphere (B).
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Magnetic resonance imaging (MRI) demonstrated corpus callosum agenesis, bilateral ventricle dilatation with right-side predominance, and a large choroid plexus cyst in the left trigone of the lateral ventricle (Figure 2A). Fluorodeoxyglucose positron emission tomography- computed tomography (PET-CT) showed hypometabolism in the right hemisphere (Figure 2B).
Intraoperative electrocorticography and postoperative imaging. (A) Intraoperative findings included absent Roland vein and ambiguous central sulcus. The sclerotic cortex was identified in the central area. (B) Intraoperative electrocorticography. (C) Postoperative axial fluid-attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) demonstrated the disconnection line. (D) Intraoperative electrocorticography before subtotal hemispherotomy. (E) Intraoperative electrocorticography after subtotal hemispherotomy.
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Operative findings indicated that the Roland vein was absent, and the central sulcus was ambiguous (Figure 3A). Subtotal hemispherotomy was performed, sparing the motor cortex (Figure 3C). Tokyo, Japan) at a sampling rate of 2,000 Hz to record intraoperative ECoG under total propofol-based intravenous anesthesia. The recording was done before and after performing the subtotal hemispherotomy and lasted 10 min at each time point (Figures 3D,E). Tokyo, Japan), consisting of 24 platinum electrodes (4-mm diameter and 10-mm distance), from the frontal to the parietal lobes (Figure 3B). The electrodes were placed over the frontal, central, and parietal areas, n = 8 in each.