Stepwise synchronization through the corpus callosum is one cause of myoclonic jerks

World Neurosurg. 2012 Feb;77(2):399.E5-8. doi: 10.1016/j.wneu.2011.07.006. Epub 2011 Nov 7.

Abstract

Background: Epileptic myoclonus is generally treated by valproate monotherapy, and this therapy has confirmed efficacy. However, almost 30% of patients with juvenile myoclonic epilepsy (JME) are valproate-resistant.

Case description: A 23-year-old man with a diagnosis of JME had resistance to multiple antiepileptic drugs (AEDs). Stepwise synchronization of bilateral spikes on electroencephalography (EEG) was found shortly before the clinical myoclonus. The anterior two thirds of the corpus callosum were divided. Desynchronization of spikes by the corpus callosotomy arrested the patient's myoclonus.

Conclusions: Interhemispheric recruitment of epileptic spikes through the corpus callosum may induce synchronization of spikes and myoclonus.

Publication types

  • Case Reports

MeSH terms

  • Anticonvulsants / therapeutic use
  • Cognition Disorders / etiology
  • Cognition Disorders / physiopathology
  • Corpus Callosum / physiopathology*
  • Corpus Callosum / surgery
  • Cortical Synchronization / physiology*
  • Drug Resistance
  • Electroencephalography
  • Functional Laterality / physiology
  • Humans
  • Isoxazoles / therapeutic use
  • Magnetic Resonance Imaging
  • Male
  • Myoclonus / etiology*
  • Myoclonus / physiopathology*
  • Myoclonus / surgery
  • Neurosurgical Procedures
  • Seizures / physiopathology
  • Syncope / etiology
  • Valproic Acid / therapeutic use
  • Young Adult
  • Zonisamide

Substances

  • Anticonvulsants
  • Isoxazoles
  • Zonisamide
  • Valproic Acid