TY - JOUR
T1 - Complete Corpus Callosotomy Brings Worthwhile Seizure Reduction in Both Pediatric and Adult Patients
AU - Ukishiro, Kazushi
AU - Osawa, Shin Ichiro
AU - Iwasaki, Masaki
AU - Kakisaka, Yosuke
AU - Jin, Kazutaka
AU - Uematsu, Mitsugu
AU - Yamamoto, Tetsuya
AU - Tominaga, Teiji
AU - Endo, Hidenori
AU - Nakasato, Nobukazu
N1 - Publisher Copyright:
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons.
PY - 2025/2/1
Y1 - 2025/2/1
N2 - BACKGROUND AND OBJECTIVES: The influence of the age at which complete corpus callosotomy (CC) surgery is performed on seizure outcomes remains unclear. This study aimed to evaluate the age-dependent aspects of long-term seizure outcomes after complete CC. METHODS: We reviewed 41 patients who underwent one-stage complete CC. Seizure outcomes were analyzed for age at epilepsy onset and at complete CC, focal MRI abnormality, and etiology. RESULTS: The median age was 7 months at epilepsy onset and 93 months at complete CC. The median follow-up duration was 67 months. Sixteen patients had focal MRI lesions and 4 had only general atrophy. Etiology was identified in 20 patients. For overall seizure outcomes (N = 41), complete seizure freedom was achieved in 5 patients, excellent seizure reduction (>80%) in 11, good (50%-80%) in 5, and poor (<50%) in 20. Freedom was correlated with younger age at complete CC and unknown etiology (P ≤.05). Freedom was only achieved in patients aged younger than 7 years. Worthwhile (≥50%, freedom, excellent, and good) and not worthwhile (<50%, poor) overall seizure reduction showed no statistical difference in age at complete CC. No related factor was found for worthwhile overall seizure reduction. For drop attack outcomes (N = 31), freedom was achieved in 22 cases, excellent in 5, and poor in 4. Freedom was correlated with younger age at complete CC (P <.05) although freedom was achieved in 4 of 7 patients older than 20 years. Age at complete CC showed no statistical difference between worthwhile (≥50%) and not worthwhile (<50%) drop attack reduction. Worthwhile drop attack reduction was correlated with unknown etiology (P <.05). Complications were mild and transient. CONCLUSION: Complete CC is an excellent surgical option based on favorable seizure outcomes and acceptable complications in our present study.
AB - BACKGROUND AND OBJECTIVES: The influence of the age at which complete corpus callosotomy (CC) surgery is performed on seizure outcomes remains unclear. This study aimed to evaluate the age-dependent aspects of long-term seizure outcomes after complete CC. METHODS: We reviewed 41 patients who underwent one-stage complete CC. Seizure outcomes were analyzed for age at epilepsy onset and at complete CC, focal MRI abnormality, and etiology. RESULTS: The median age was 7 months at epilepsy onset and 93 months at complete CC. The median follow-up duration was 67 months. Sixteen patients had focal MRI lesions and 4 had only general atrophy. Etiology was identified in 20 patients. For overall seizure outcomes (N = 41), complete seizure freedom was achieved in 5 patients, excellent seizure reduction (>80%) in 11, good (50%-80%) in 5, and poor (<50%) in 20. Freedom was correlated with younger age at complete CC and unknown etiology (P ≤.05). Freedom was only achieved in patients aged younger than 7 years. Worthwhile (≥50%, freedom, excellent, and good) and not worthwhile (<50%, poor) overall seizure reduction showed no statistical difference in age at complete CC. No related factor was found for worthwhile overall seizure reduction. For drop attack outcomes (N = 31), freedom was achieved in 22 cases, excellent in 5, and poor in 4. Freedom was correlated with younger age at complete CC (P <.05) although freedom was achieved in 4 of 7 patients older than 20 years. Age at complete CC showed no statistical difference between worthwhile (≥50%) and not worthwhile (<50%) drop attack reduction. Worthwhile drop attack reduction was correlated with unknown etiology (P <.05). Complications were mild and transient. CONCLUSION: Complete CC is an excellent surgical option based on favorable seizure outcomes and acceptable complications in our present study.
KW - Corpus callosotomy
KW - Drug-resistant epilepsy
KW - Epilepsy surgery
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U2 - 10.1227/neu.0000000000003092
DO - 10.1227/neu.0000000000003092
M3 - Article
C2 - 38953628
AN - SCOPUS:85214981157
SN - 0148-396X
VL - 96
SP - 410
EP - 415
JO - Neurosurgery
JF - Neurosurgery
IS - 2
ER -