scholarly journals Seizure outcome after corpus callosotomy in a large paediatric series

2017 ◽  
Vol 60 (2) ◽  
pp. 199-206 ◽  
Author(s):  
David Graham ◽  
Deepak Gill ◽  
Russell C Dale ◽  
Martin M Tisdall ◽  
Keyword(s):  
Seizure Outcome ◽  
Corpus Callosotomy

scholarly journals Epilepsy surgery in tuberous sclerosis complex: the BC Children’s Hospital experience

2015 ◽  
Vol 42 (S1) ◽  
pp. S14-S14
Author(s):  
C Wilbur ◽  
C Sanguansermsri ◽  
H Chable ◽  
A Mihaela ◽  
P Steinbok ◽  
...  
Keyword(s):  
Tuberous Sclerosis ◽  
Epilepsy Surgery ◽  
Tuberous Sclerosis Complex ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Seizure Outcome ◽  
Corpus Callosotomy ◽  
Age At Surgery ◽  
Second Resection

Background: Epilepsy occurs in up to 90% of patients with Tuberous Sclerosis Complex (TSC) and is often refractory to medications. Our objective was to assess the safety and outcome of epilepsy surgery in children with TSC at our institution. Methods: We performed a systematic, retrospective chart review of children with TSC who underwent epilepsy surgery at our institution. Patients were identified through epilepsy and clinical neurophysiology databases. Results: 19 patients (out of 81 with TSC) underwent surgery between 1995-2014. Median age at surgery was 4.2 (Range 1.1-15.6) years, with patients having failed a median 4 (Range 0-10) anti-seizure medications. Surgery comprised corpus callosotomy in 2 and resection of one or more tubers in 17. 2 patients had a subsequent second resection. Minor neurologic deficits occurred after 14% of surgeries. Median follow-up was 2.4 years (Range 0.3 -13.8 years) following surgery . At last follow-up, 47% were seizure free, including 2 patients off anti-seizure medication. Conclusions: Epilepsy surgery is safe and effective in carefully selected TSC patients, with the majority having a good seizure outcome. Children with epilepsy secondary to TSC should be referred for epilepsy surgery assessment.

scholarly journals Seizure Outcome after Anterior versus Complete Corpus Callosotomy in Children: A Systematic Review with Meta-Analysis

2015 ◽  
Vol 34 (04) ◽  
pp. 304-308
Author(s):  
Rodrigo Adry ◽  
Sebastião Silva Júnior ◽  
Carlos Pereira ◽  
Jean Oliveira ◽  
Dionei Morais ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Seizure Outcome ◽  
Corpus Callosotomy

Seizure Outcomes After Corpus Callosotomy for Drop Attacks

Neurosurgery ◽  
2013 ◽  
Vol 73 (6) ◽  
pp. 993-1000 ◽  
Author(s):  
Regina S. Bower ◽  
Elaine Wirrell ◽  
Macaulay Nwojo ◽  
Nicholas M. Wetjen ◽  
W. Richard Marsh ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Intractable Epilepsy ◽  
Seizure Outcome ◽  
Seizure Onset ◽  
Corpus Callosotomy ◽  
Drop Attacks ◽  
Younger Age ◽  
Age At Surgery ◽  
Adults And Children

Abstract BACKGROUND: Medically intractable epilepsy involving drop attacks can be difficult to manage and negatively affect quality of life. Most studies investigating the effect of corpus callosotomy (CC) on seizures have been limited, focusing on the pediatric population or drop seizures alone, with little attention to other factors influencing seizure outcome. OBJECTIVE: To assess seizure outcomes after CC in adults and children. METHODS: Retrospective analysis was performed on all patients who underwent CC (anterior two thirds, 1- or 2-stage complete) at our institution between 1990 and 2011. Change in frequency after CC was assessed for drop seizures and other seizure types. Multiple factors were evaluated for impact on seizure outcome. RESULTS: Fifty patients met inclusion criteria. The median age was 1.5 years at seizure onset and 17 years at time of surgery. Anterior two-thirds CC was performed in 28 patients, 1-stage complete in 17, and 2-stage complete in 5. All 3 groups experienced a significant decrease in drop seizures (P < .001, P < .001, and P = .020, respectively), with 40% experiencing complete resolution, and 64% dropping at least 1 frequency category. Other seizure types significantly decreased in anterior two-thirds CC and 1-stage complete (P = .0035, P = .001, respectively). Younger age at surgery correlated with better seizure outcomes (P = .043). CONCLUSION: CC for medically refractory generalizing epilepsy is effective for both drop seizures and other seizure types. CC should be considered soon after a patient has been deemed medically refractory because earlier age at surgery results in lower risk and better outcome.

scholarly journals Corpus Callosotomy for Intractable Epilepsy Revisited: The Children’s Hospital of Michigan Series

2017 ◽  
Vol 32 (7) ◽  
pp. 624-629 ◽  
Author(s):  
Aimee F. Luat ◽  
Eishi Asano ◽  
Ajay Kumar ◽  
Harry T. Chugani ◽  
Sandeep Sood
Keyword(s):  
Vagus Nerve ◽  
Intractable Epilepsy ◽  
Endoscopic Approach ◽  
Seizure Outcome ◽  
Nerve Stimulator ◽  
Corpus Callosotomy ◽  
Seizure Reduction ◽  
Palliative Procedure ◽  
Vagus Nerve Stimulator ◽  
Drug Resistant Epilepsy

Corpus callosotomy is a palliative procedure performed to reduce the severity of drug-resistant epilepsy. The authors assessed its efficacy on different seizure types in 20 subjects (age range 5-19 years); 8 with active vagus nerve stimulator. Fifteen had complete callosotomy, 3 had anterior 2/3, and 2 had anterior 2/3 followed later by complete callosotomy. Ten had endoscopic approach. In all, 65% had ≥ 50% reduction of generalized seizures leading to falls (atonic, tonic, myoclonic); 35% became seizure-free (follow-up period: 6 months to 9 years; mean 3 years). Seizure outcome distribution was better for generalized than for partial seizures ( P = .003). Endoscopic approach was as effective as transcranial approach. Seven subjects who failed vagus nerve stimulator therapy responded with ≥50% seizure reduction. Corpus callosotomy is an effective treatment for intractable generalized epilepsy leading to falls with significant seizure reduction or even elimination of seizures, in the majority of children.

Seizure outcome after corpus callosotomy: the Taiwan experience

2000 ◽  
Vol 16 (2) ◽  
pp. 87-92 ◽  
Author(s):  
S. -Y. Kwan ◽  
T. -T. Wong ◽  
K. -P. Chang ◽  
C. -S. Chi ◽  
T. -F. Yang ◽  
...  
Keyword(s):  
Seizure Outcome ◽  
Corpus Callosotomy

Complete versus anterior two-thirds corpus callosotomy in children: analysis of outcome

2010 ◽  
Vol 6 (3) ◽  
pp. 257-266 ◽  
Author(s):  
Laleh Jalilian ◽  
David D. Limbrick ◽  
Karen Steger-May ◽  
Jim Johnston ◽  
Alex K. Powers ◽  
...  
Keyword(s):  
Antiepileptic Drugs ◽  
Class I ◽  
Seizure Outcome ◽  
Corpus Callosotomy ◽  
Female Ratio ◽  
Disconnection Syndrome ◽  
Parental Assessment ◽  
Initial Procedure ◽  
Clinically Significant ◽  
Daily Function

Object The goal of this study was to evaluate the efficacy of anterior versus complete sectioning of the corpus callosum in children suffering from medically refractory epilepsy. The authors report seizure outcome in patients who underwent anterior two-thirds or complete corpus callosotomy (CC) during the period 1995–2008 at St. Louis Children's Hospital. Methods The medical records of 27 children and adolescents with a minimum follow-up of 6 months were retrospectively evaluated with respect to seizure status, anticonvulsant outcomes, and subjective results. Preoperatively, patients suffered from a variety of seizure types that occurred daily, weekly, or episodically. The male/female ratio was 19:8, and patients ranged in age between 3 and 19 years (mean 9.93 years). Seizure outcome, parental assessment of daily function, and changes in the number of prescribed antiepileptic drugs were all assessed. Results Fifteen patients underwent an initial anterior two-thirds CC, and 12 underwent a complete CC. Of the 15 patients who underwent an anterior CC, 7 went on to receive a posterior CC. Seizure control was superior in children undergoing a complete CC (91%, Class I–III) versus an anterior two-thirds CC (75%, Class I–III). Seizure types most affected by CC included atonic, myoclonic, and absence. The number of postoperative antiepileptic drugs did not significantly change following CC in either the anterior only or complete groups. One patient experienced a transient disconnection syndrome that resolved within 4 weeks, and 4 patients experienced mild hemiparesis and speech delays that resolved with therapy. Three patients experienced surgical complications requiring a second operation. The overall daily function and attentiveness of the patients improved. Conclusions A complete CC should be considered as the initial procedure in lower-functioning children afflicted by absence, atonic, or myoclonic seizures. Severely affected higher-functioning children may also benefit from a complete CC, without clinically significant disconnection syndromes. A completion posterior CC may benefit patients in whom a prior anterior CC has failed.

scholarly journals Rates and predictors of seizure outcome after corpus callosotomy for drug-resistant epilepsy: a meta-analysis

2019 ◽  
Vol 130 (4) ◽  
pp. 1193-1202 ◽  
Author(s):  
Alvin Y. Chan ◽  
John D. Rolston ◽  
Brian Lee ◽  
Sumeet Vadera ◽  
Dario J. Englot
Keyword(s):  
Meta Analysis ◽  
Palliative Surgery ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Drug Resistant ◽  
Corpus Callosotomy ◽  
Mri Findings ◽  
Drop Attacks ◽  
Drop Attack ◽  
Drug Resistant Epilepsy

OBJECTIVECorpus callosotomy is a palliative surgery for drug-resistant epilepsy that reduces the severity and frequency of generalized seizures by disconnecting the two cerebral hemispheres. Unlike with resection, seizure outcomes remain poorly understood. The authors systematically reviewed the literature and performed a meta-analysis to investigate rates and predictors of complete seizure freedom and freedom from drop attacks after corpus callosotomy.METHODSPubMed, Web of Science, and Scopus were queried for primary studies examining seizure outcomes after corpus callosotomy published over 30 years. Rates of complete seizure freedom or drop attack freedom were recorded. Variables showing a potential relationship to seizure outcome on preliminary analysis were subjected to formal meta-analysis.RESULTSThe authors identified 1742 eligible patients from 58 included studies. Overall, the rates of complete seizure freedom and drop attack freedom after corpus callosotomy were 18.8% and 55.3%, respectively. Complete seizure freedom was significantly predicted by the presence of infantile spasms (OR 3.86, 95% CI 1.13–13.23), normal MRI findings (OR 4.63, 95% CI 1.75–12.25), and shorter epilepsy duration (OR 2.57, 95% CI 1.23–5.38). Freedom from drop attacks was predicted by complete over partial callosotomy (OR 2.90, 95% CI 1.07–7.83) and idiopathic over known epilepsy etiology (OR 2.84, 95% CI 1.35–5.99).CONCLUSIONSThe authors report the first systematic review and meta-analysis of seizure outcomes in both adults and children after corpus callosotomy for epilepsy. Approximately one-half of patients become free from drop attacks, and one-fifth achieve complete seizure freedom after surgery. Some predictors of favorable outcome differ from those in resective epilepsy surgery.

scholarly journals Predictive Value of Electroencephalography for Seizure Outcome Following Corpus Callosotomy in Children

2011 ◽  
Vol 1 (2) ◽  
pp. 65-70 ◽  
Author(s):  
Go-Un Jeong ◽  
Hunmin Kim ◽  
Byung Chan Lim ◽  
Jong-Hee Chae ◽  
Ki Joong Kim ◽  
...  
Keyword(s):  
Predictive Value ◽  
Seizure Outcome ◽  
Corpus Callosotomy

scholarly journals Corpus callosotomy for treatment of drug-resistant epilepsy: a review of 16 pediatric cases in northern Vietnam

2020 ◽  
Vol 25 (6) ◽  
pp. 582-587
Author(s):  
Nguyen Duc Lien ◽  
Dang Anh Tuan ◽  
Cao Vu Hung ◽  
Jacob R. Lepard ◽  
Brandon G. Rocque
Keyword(s):  
Neurological Deficits ◽  
Seizure Outcome ◽  
Drug Resistant ◽  
Imaging Findings ◽  
Corpus Callosotomy ◽  
Resource Limited Settings ◽  
Resource Limited ◽  
Drug Resistant Epilepsy ◽  
Postoperative Seizure

OBJECTIVEThe aim of this study was to evaluate postoperative seizure outcome in children with drug-resistant epilepsy not eligible for focal resection who underwent corpus callosotomy.METHODSThe study included 16 patients undergoing corpus callosotomy between September 2015 and May 2018. Seizure semiology and frequency, psychomotor status, and video electroencephalography and imaging findings were evaluated for all patients.RESULTSOf the 16 patients who underwent callosotomy during the study period, 11 underwent complete callosotomy and 5 underwent anterior only. Seizure improvement greater than 75% was achieved in 37.5% of patients, and another 50% of patients had seizure improvement of 50%–75%. No sustained neurological deficits were observed in these patients. There were no significant complications. Duration of postoperative follow-up ranged from 12 to 44 months.CONCLUSIONSCorpus callosotomy is an effective treatment for selected patients with drug-resistant epilepsy not eligible for focal resection in resource-limited settings. Fostering and developing international epilepsy surgery centers should remain a high priority for the neurosurgical community at large.

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