FRONTAL DISCONNECTION IN A CASE OF MILD MALFORMATION OF CORTICAL DEVELOPMENT WITH OLIGODENDROGLIAL HYPERPLASIA AND EPILEPSY.

De Benedictis, Alessandro; Ferlito, Davide; Barba, Matteo; Herur-Raman, Aalap; Chiarello, Daniela; de Palma, Luca; Rossi-Espagnet, Maria Camilla; Randi, Franco et al. · World Neurosurg · 2026

case_report · Level V

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Abstract

Frontal disconnection is an effective technique for the treatment of different forms of drug-resistant epilepsy associated with lobar encephalopathies. We describe the case of a 7-year-old child who underwent right prefrontal disconnection and anterior insular resection. The procedure involves sequential steps aiming to interrupt both inter-hemispheric and intra-hemispheric anterior white matter connectivity. Histopathological analysis revealed a MOGHE, a recently recognized histopathological entity associated with multiple types of drug-resistant epilepsy. <sup>1-3</sup> At the early 11 early month follow-up, the patient remained seizure free without residual motor deficit and showed neurocognitive improvement. The video illustrates the main surgical steps, incorporating intraoperative footage and advanced three-dimensional neuroimaging modeling. Patient' parents consented to the procedure. The participants and any identifiable individuals consented to publication of his/her image. Considering the retrospective nature of the analysis, the current study did not require the approval of the local ethics committee according to current legislation, but a notification was sent.