Dominant, Lesional Congenital Hemispheric Epilepsy

This chapter presents a patient with pharmacoresistant lesional and dominant hemispheric epilepsy due to a porencephalic cyst undergoing anterior corpus callosotomy and partial frontal lobe resection. We address the indications, approaches, outcomes, and complications of corpus callosotomy. We describe the various and complex symptoms that comprise disconnection syndrome following corpus callosotomy. We discuss the etiologies, the EEG and neuroimaging findings in patients with porencephalic cysts. We briefly discuss the significance and implication of thalamic hypometabolism in epilepsy. Lastly, we review the symptomatogenesis of focal and generalized atonic seizures, asymmetric tonic, and startle-induced seizures.