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KMID : 0877220020060010015
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Journal of Korean Epilepsy Society
2002 Volume.6 No. 1 p.15 ~ p.19
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Outcome after Corpus Callosotomy in Intractable Epilepsy
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Lee Hyun-Wook
Hong Seung-Chyul
Hong Seung-Bong
Seo Dae-Won
Lee Mun-Hyang
Kim Jong-Hyun
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Abstract
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Background: The authors present the results of a series of corpus callosotomies in 6 patients performed from 1998 to 2001 at the Samsung Medical Center.
Methods: Patients with medically intractable siezures, frequent drop attacks, poorly localized partial seizures with secondary generalization and generalized seizures were accepted as candidates (patients aged 14-29 years, 3 male and 3 female, with mean age at surgery of 18.6 years). Preoperatively, the frequency of seizures ranged from 2 to 600 per month. The standard microsurgical technique performed was a corpus callosotomy by the same surgeon under general anesthesia (anterior two-thirds corpus callosotomy was done in 4 cases, total callosotomy was done in 2 cases). In two cases, an additional cortical resection after electrocorticography using subdural electrode monitoring was carried out. The results were evaluated after a mean follow-up of 22 months (range, 4-34). We evaluated the effect of surgery according to the Engel classification.
Results: Complete freedom from seizures was noted in 2 cases (33%). More than 75% of reduction in seizure frequency was noted in 3 cases (50%). There was no significant reduction in frequency of seizure in one case. The highest rate of significant improvement was noted in the patients with drop attacks (75%(3/4)) and generalized tonic-clonic seizures (75%(3/4)). In one patient, pseudoaneurysm was complicated postoperatively but successful treatment was performed by endovascular procedure. Otherwise, there were no major postoperative complications except for brief mutism, slow activity and abnormal movement of one leg during the several weeks postoperatively.
Conclusion: We conclude that corpus callosotomy is a safe alternative treatment for the medically intractable seizures, especially drop attack and generalized epilepsy.
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KEYWORD
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Callosotomy, Corpus callosum, Outcome
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