Case Report: Behavioral Disorder Following Hemispherotomy: A Valproate Effect?
Background: Hemispherotomy is an epilepsy surgery procedure applied to cure particularly pharmacorefractory lesional epilepsy due to unihemispheric pathologies. Such a disconnection of an entire hemisphere is followed by reorganizational processes.Methods: We describe an acute aggravation of behavio...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:f65d3cc6bb494a8b8394f27dd7a67d712021-12-01T18:45:35ZCase Report: Behavioral Disorder Following Hemispherotomy: A Valproate Effect?1664-229510.3389/fneur.2021.764376https://doaj.org/article/f65d3cc6bb494a8b8394f27dd7a67d712021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.764376/fullhttps://doaj.org/toc/1664-2295Background: Hemispherotomy is an epilepsy surgery procedure applied to cure particularly pharmacorefractory lesional epilepsy due to unihemispheric pathologies. Such a disconnection of an entire hemisphere is followed by reorganizational processes.Methods: We describe an acute aggravation of behavioral problems following a hemispherotomy in a patient treated with valproic acid, which subsided once valproate was discontinued.Results: A 9-year-old boy with drug-resistant epilepsy caused by the residua of a perinatal stroke treated for several years with valproic acid and lamotrigine underwent hemispherotomy. Shortly after surgery, minimal preoperative behavioral problems intensified dramatically, and aggression occurred as a new symptom. Assuming a correlation between valproate treatment and the postoperative altered neuronal network, we tapered off valproate. The behavioral problems decreased in intensity with the reduction of valproate dose and disappeared after drug discontinuation.Conclusion: We describe severe behavioral problems after hemispherotomy that subsided when valproate was tapered off. While we cannot rule out a spontaneous correction of a post-hemispherotomy network dysregulation, our report raises awareness to possible altered effects of the anticonvulsant valproic acid parallel to reorganizational processes after hemispherotomy.Konstantin L. MakridisKonstantin L. MakridisKonstantin L. MakridisSebastian TrillerSebastian TrillerDeniz A. AtalayDeniz A. AtalayChristine PragerChristine PragerChristian E. ElgerChristian E. ElgerChristian E. ElgerAngela M. KaindlAngela M. KaindlAngela M. KaindlFrontiers Media S.A.articledrug resistant epilepsypediatricsbehavioral problemschildrenvalproic acidepilepsy surgeryNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021) |
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drug resistant epilepsy pediatrics behavioral problems children valproic acid epilepsy surgery Neurology. Diseases of the nervous system RC346-429 |
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drug resistant epilepsy pediatrics behavioral problems children valproic acid epilepsy surgery Neurology. Diseases of the nervous system RC346-429 Konstantin L. Makridis Konstantin L. Makridis Konstantin L. Makridis Sebastian Triller Sebastian Triller Deniz A. Atalay Deniz A. Atalay Christine Prager Christine Prager Christian E. Elger Christian E. Elger Christian E. Elger Angela M. Kaindl Angela M. Kaindl Angela M. Kaindl Case Report: Behavioral Disorder Following Hemispherotomy: A Valproate Effect? |
| description |
Background: Hemispherotomy is an epilepsy surgery procedure applied to cure particularly pharmacorefractory lesional epilepsy due to unihemispheric pathologies. Such a disconnection of an entire hemisphere is followed by reorganizational processes.Methods: We describe an acute aggravation of behavioral problems following a hemispherotomy in a patient treated with valproic acid, which subsided once valproate was discontinued.Results: A 9-year-old boy with drug-resistant epilepsy caused by the residua of a perinatal stroke treated for several years with valproic acid and lamotrigine underwent hemispherotomy. Shortly after surgery, minimal preoperative behavioral problems intensified dramatically, and aggression occurred as a new symptom. Assuming a correlation between valproate treatment and the postoperative altered neuronal network, we tapered off valproate. The behavioral problems decreased in intensity with the reduction of valproate dose and disappeared after drug discontinuation.Conclusion: We describe severe behavioral problems after hemispherotomy that subsided when valproate was tapered off. While we cannot rule out a spontaneous correction of a post-hemispherotomy network dysregulation, our report raises awareness to possible altered effects of the anticonvulsant valproic acid parallel to reorganizational processes after hemispherotomy. |
| format |
article |
| author |
Konstantin L. Makridis Konstantin L. Makridis Konstantin L. Makridis Sebastian Triller Sebastian Triller Deniz A. Atalay Deniz A. Atalay Christine Prager Christine Prager Christian E. Elger Christian E. Elger Christian E. Elger Angela M. Kaindl Angela M. Kaindl Angela M. Kaindl |
| author_facet |
Konstantin L. Makridis Konstantin L. Makridis Konstantin L. Makridis Sebastian Triller Sebastian Triller Deniz A. Atalay Deniz A. Atalay Christine Prager Christine Prager Christian E. Elger Christian E. Elger Christian E. Elger Angela M. Kaindl Angela M. Kaindl Angela M. Kaindl |
| author_sort |
Konstantin L. Makridis |
| title |
Case Report: Behavioral Disorder Following Hemispherotomy: A Valproate Effect? |
| title_short |
Case Report: Behavioral Disorder Following Hemispherotomy: A Valproate Effect? |
| title_full |
Case Report: Behavioral Disorder Following Hemispherotomy: A Valproate Effect? |
| title_fullStr |
Case Report: Behavioral Disorder Following Hemispherotomy: A Valproate Effect? |
| title_full_unstemmed |
Case Report: Behavioral Disorder Following Hemispherotomy: A Valproate Effect? |
| title_sort |
case report: behavioral disorder following hemispherotomy: a valproate effect? |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/f65d3cc6bb494a8b8394f27dd7a67d71 |
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