Anterior corpus callosotomy in multistep invasive monitoring and surgery for atonic seizures
Bibliographic record
Abstract
Identifying the epileptogenic zone (EZ) in patients with refractory nonlesional frontal lobe epilepsy is frequently challenging. Intracranial EEG (icEEG) recordings are often required to better delineate the EZ, but the presence of an extensive network of connections allowing rapid ictal spread may result in bilateral homologous regional (or extremely diffuse) electrical ictal patterns. Here, we report a case where callosotomy performed after a first nonlateralizing icEEG study allowed for adequate identification of the EZ. The patient, an 18-year-old left-handed woman with daily atonic spells, had synchronous interictal and ictal epileptic activity from both supplementary motor areas (SMAs) during icEEG. Anterior partial callosotomy localized the EZ to the right SMA, as seizures were no longer associated with mirror-image ictal activity over the left SMA. Right SMA resection led to seizure freedom (follow-up of 23 months). This case exemplifies how a partial callosotomy followed by further icEEG recordings may adequately localize the EZ when initial icEEG recordings reveal bilateral synchronous focal or regional ictal activities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".