Corpus Callosum Section for Control of Clinically and Electroencephalo-Graphically Classified Intractable Seizures

Rayport, Mark; Corrie, W. Stephen; Ferguson, Shirley M.

doi:10.1007/978-1-4613-2419-5_16

Cited by 12 publications

(6 citation statements)

References 13 publications

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“…Patients who suffer from either of those seizures have an excellent, almost equal, chance of improvement (up to 85%) following anterior callosotomy. Other series have reported a reduction of up to 80% [1,10,16], complete elimination of akinetic drop attacks [9], or a significant similar decrease in both GTC seizures and drop attacks (up to 75-80%) [1,8,9,22,23,27]. In many patients in our series, the intensity or quality of the seizures varied.…”

Section: Discussionmentioning

confidence: 73%

Anterior callosotomy in the management of intractable epileptic seizures: Significance of the extent of resection

Sakas

Phillips

1996

Acta neurochir

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We report our series of twenty consecutive patients who underwent corpus callosotomy for medically intractable epilepsy. The follow-up is 6.7 +/- 0.5 years. Sixteen of 20 patients (80%) had a favourable outcome. Six patients have remained free of major generalized motor seizures, and ten further patients experienced significant sustained reduction in the severity and frequency of the seizures. The type of seizures associated with improved outcome were drop attacks, and generalized tonic-clonic seizures, in 11 of 13 (85%) and 14 of 18 (78%) of the patients, respectively. In order to establish the extent of necessary callosal resection to achieve seizure control, the outcome of patients was correlated with the extent of callosal sectioning on postoperative magnetic resonance imaging. This study confirms that an anterior callosal resection of two-thirds (or 65%) is sufficient to achieve significant improvement in seizure control with an acceptable morbidity in judiciously selected patients with medically intractable epilepsy. Results also suggest that the patient's history and clinical classification of the seizures have prognostic value as selection criteria for patients referred for this operation. In this series, no prognostic value was established for pre-operative electroencephalographic patterns, or neuroimaging findings.

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Section: Discussionmentioning

confidence: 73%

Anterior callosotomy in the management of intractable epileptic seizures: Significance of the extent of resection

Sakas

Phillips

1996

Acta neurochir

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“…The Yale data are similar, with 75% of patients achieving an elimination of tonic-clonic episodes after apparent total corpus callosotomy (Spencer et a]., 1987~). Rayport et al (1985) noticed elimination in two of six and a decrease in three.…”

Section: Discussionmentioning

confidence: 93%

“…In recent years, corpus callosum section has experienced increased popularity, largely as a result of the efforts of Wilson et al (1975Wilson et al ( , 1977Wilson et al ( , 1978 from Dartmouth. Nonetheless, despite several years of evolution in the procedure, a clear consensus on the indications for its application has not been identified from the literature to date (Spencer et al, 1983;Blume, 1984;Gates et al, 1984;Spencer et al, 1984;Rayport et al, 1985;Saint-Hilaire et al, 1985).…”

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confidence: 99%

Response of Multiple Seizure Types to Corpus Callosum Section

et al. 1987

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Twenty-four patients (16 men, 8 women) underwent corpus callosum section specifically for improvement of control of atonic or tonic seizures that resulted in falls and injuries. All patients suffered from multiple seizure types, including complex partial (CP) and tonic-clonic (TC) seizures, in addition to the tonic or atonic episodes. Preoperative seizure frequency was quantified for all types for 1 year immediately before surgery and for the most recent year since the procedure; average monthly counts were obtained for each seizure type. The period of follow-up since surgery averaged 43 months (range, 23-79 months). Statistically significant improvements were documented, not only for the atonic/tonic seizures (p less than 0.0001) for all patients, but also for TC seizures (17 patients; p less than 0.001) and CP seizures (20 patients; p less than 0.02). Six patients experienced an exacerbation of CP seizures postoperatively, and three developed new simple partial (SP) seizures. In all of the CP group and all three of the SP group, ictal video and EEG features suggested that the new seizures were an aborted expression of the previously generalized seizures. From these data, we conclude that callosotomy is an effective treatment for tonic, atonic, and TC seizures intractable to anticonvulsant medications. Three patients became seizure free. The procedure may also be useful for certain specific subgroups of CP epilepsy, but further studies are required before expanding callosotomy to intractable CP seizures not amenable to focal resection.

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“…Almost all patients have a near complete or complete cessation of this type of seizure after complete callosal section [13][14][15]. Partial section may also control these seizures, but the likelihood of control is about half of that seen with complete section [16][17][18][19], Other generalized seizures, such as tonic, and tonic-clonic, have also been controlled with corpus callosotomy, with about 75% of patients having a meaningful reduction in seizure frequency [10,11,17,[20][21][22], Few reported series, and no large series, of patients undergoing corpus callosotomy have focused on the pedi atric population, although most large series do include a few pediatric patients. Geoffroy et al [23] reported on 9 patients from 5 to 16 years of age.…”

Section: Discussionmentioning

confidence: 99%