Outcome and long term follow-up after corpus callosotomy in childhood onset intractable epilepsy

Abstract

Corpus callosotomy remains to be a fairly good choice of surgical treatment for childhood onset medically intractable epilepsy in selected patients.

Clinical Development of Corpus Callosotomy in Treating Refractory Seizure

“…In another study, nearly three-fourths of the parents appreciated improvements in behavior and attentiveness of their children (Turanli et al, 2006). Activities of daily living including level of self-care, family life, and even school attendance may improve significantly (Turanli et al, 2006). Intelligence quotient scores do not usually change significantly after callosotomy.…”

“…Changes included improvement in hyperactivity (93%), emotional well-being (42%), social contacts (36%), speech function (21%), and memory function (17%) (Maehara & Shimizu, 2001). In another study, nearly three-fourths of the parents appreciated improvements in behavior and attentiveness of their children (Turanli et al, 2006). Activities of daily living including level of self-care, family life, and even school attendance may improve significantly (Turanli et al, 2006).…”

“…Intelligence quotient scores do not usually change significantly after callosotomy. However, in some patients with marked impairment of cognitive and language functions in whom a favorable seizure outcome has been achieved, an improvement in overall intelligence and language abilities has been observed (Maehara & Shimizu, 2001;Turanli et al, 2006;Rathore et al, 2007). This improvement is probably due to the decrease in seizure frequency or consequent decrease in antiepileptic drug load, or both.…”

Intractable Epilepsy in Childhood: Presurgical Evaluation and Treatment

“…[42] Bazen cerrahi sınır tam olarak belirlenemez ve sadece fonksiyonel/palyatif cerrahi yöntemler uygulanır. Atonik/ tonik düşme atakları için CC, [43,44] dirençli parsiyel epilepsi ve Lennox-Gastaut Sendromu için VNS buna örnektir. [45,46] Nörostimulasyon, VNS ile sınırlı kalmayıp derin beyin stimulasyonu [47] ve 'Responsive (Closed-Loop) Stimulation' [48] çalışmaları devam etmektedir.…”

Surgical treatment of intractable epilepsy associated with focal cortical dysplasia

“…19 A hemispheric disconnection procedure such as a functional hemispherectomy may be used when multiple independent spike foci are present throughout the hemisphere or when neuroimaging or surface EEG cannot identify unique loci of seizure onset. 30 Anterior corpus callosotomy may be considered in patients with bihemispheric MCD or FCD who suffer from drop attacks or intense head drop seizures 35,62 and who would not be candidates for focal cortical or lesion resections due to multifocal disease. The rate of repeated operation for FCDs is 3-14%.…”