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Clínica de Epilepsia | Trabalhos em Congressos

INTERHEMISPHERIC TRANSFER IN PATIENTS SUBMITTED TO PARTIAL CALLOSAL SECTIONS

Ana Regina Caner-Cukiert and Arthur Cukiert, M.D. PhD.

Epilepsy Surgery Program, Hospital Brigadeiro and Epilepsy Clinic, Sao Paulo SP, Brazil.

Rationale: To study the patterns of interhemispheric transfer in patients with secondary generalized seizures submitted to partial callosal sections sparing the splenium. To study the patterns of interhemispheric transfer in patients with secondary generalized seizures submitted to partial callosal sections sparing the splenium.

Methods: Eleven patients submitted to anterior callosal sections were evaluated by means of an extensive neuropsychological interhemispheric transfer protocol that included bimanual coordination, tactile, cinestesic, stereognosis, praxis and dichotic listening testing. All had the extention of their callosal section defined by post-operative MRI scanning. Eleven patients submitted to anterior callosal sections were evaluated by means of an extensive neuropsychological interhemispheric transfer protocol that included bimanual coordination, tactile, cinestesic, stereognosis, praxis and dichotic listening testing. All had the extention of their callosal section defined by post-operative MRI scanning.

Results: Anterior callosal sections, especially those including the fibers connecting the rolandic regions (near to the middle of the corpus of the corpus callosal), caused deficits in the execution of bimanual alternate tasks. Tasks including simultaneous bimanual movements showed no deficits. These deficits are not restricted to poor responses to verbal commands with the left hand (in patients with left hemisphere dominance). Anterior callosal sections, especially those including the fibers connecting the rolandic regions (near to the middle of the corpus of the corpus callosal), caused deficits in the execution of bimanual alternate tasks. Tasks including simultaneous bimanual movements showed no deficits. These deficits are not restricted to poor responses to verbal commands with the left hand (in patients with left hemisphere dominance).

Conclusion: Contrary to some previous reports that anterior callosal sections do not introduce interhemispheric neuropsychological deficits, our findings suggest that even in patients with variable degrees of pre-operative cognitive impairment, it is possible to detect interhemispheric transfer deficits, especially if the section includes more then 50% of the corpus callosum. Contrary to some previous reports that anterior callosal sections do not introduce interhemispheric neuropsychological deficits, our findings suggest that even in patients with variable degrees of pre-operative cognitive impairment, it is possible to detect interhemispheric transfer deficits, especially if the section includes more then 50% of the corpus callosum.