Down syndrome associated moyamoya may worsen epilepsy control and can benefit from surgical revascularization

Sarah R Garson; Stephen J Monteith; Sheila D Smith; Bart P Keogh; Ryder P Gwinn; Michael J Doherty

doi:10.1016/j.ebcr.2018.09.008

Down syndrome associated moyamoya may worsen epilepsy control and can benefit from surgical revascularization

Epilepsy Behav Case Rep. 2018 Oct 9:11:14-17. doi: 10.1016/j.ebcr.2018.09.008. eCollection 2019.

Authors

Sarah R Garson¹, Stephen J Monteith², Sheila D Smith³, Bart P Keogh⁴, Ryder P Gwinn^{2

3}, Michael J Doherty^{1

3}

Affiliations

¹ Swedish Epilepsy Center, Seattle, WA, USA.
² Swedish Neuroscience Institute, Department of Neurosurgery, Seattle, WA, USA.
³ Swedish Neuroscience Institute, Department of Neurology, Seattle, WA, USA.
⁴ Radia Neuroimaging, Seattle, WA, USA.

Abstract

Objectives: To examine outcome of bilateral extracranial to intracranial (EC-IC) bypass surgeries for a Down syndrome patient with hard-to-treat epilepsy and moyamoya.

Materials and methods: Superficial temporal arteries were anastamosed using an indirect bypass technique to middle cerebral arteries bilaterally to help limit perfusion deficits and seizure controls.

Results: Two superficial temporal to middle cerebral artery indirect bypass surgeries were performed within 3 months. Post-revascularization improvements included seizure control, gait, perfusion, wakefulness, language and quality of life.

Conclusion: In patients with Down syndrome and moyamoya, improvements in seizure control and quality of life may occur with EC-IC bypass procedures.

Keywords: Bypass; Perfusion; Stenosis.

Publication types

Case Reports