Ahead of Print: Seizure Outcomes Following Corpus Callosotomy for Drop Attacks

Background: Medically intractable epilepsy involving drop attacks can be difficult to manage and negatively impact 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 following CC in adults and children.

Methods: Retrospective analysis was performed on all patients who underwent CC (anterior two-thirds, 1-stage complete, 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. Median age was 1.5 years at seizure onset, and 17 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 three groups experienced a significant decrease in drop seizures (p<0.001, p<0.001, and p=0.020, respectively), with 40% experiencing complete resolution, and 64% dropping at least one frequency category. Other seizure types significantly decreased in anterior 2/3 CC and 1-stage complete (p=0.0035, p=0.001, respectively). Decreasing age at surgery correlated with better seizure outcomes (p=0.043).

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, as earlier age at surgery results in lower risk and better outcome.

From: Seizure Outcomes Following Corpus Callosotomy for Drop Attacks by Bower et al.

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