Changing the paradigm of 1-stage total callosotomy for the treatment of pediatric generalized epilepsy

Kyu Won Shim, Young Mok Lee, Heung Dong Kim, Jun Soo Lee, Joong Uhn Choi, Dong Seok Kim

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Object. The authors propose that anterior callosotomy - thought to have some advantages over total callosotomy - is not superior to total callosotomy for prevention of seizure propagation or other complications. Methods. The study comprised 34 patients in whom generalized epilepsy syndrome or frontal lobe seizures with a secondary generalization were diagnosed. Preoperatively, all patients suffered from disabling drop attacks or intense head-drop seizures, and some patients also experienced other types of seizures. The male/female ratio was 22:12, and patients ranged in age between 1 to 19 years (mean 8.7 years). The follow-up period ranged from 1.08 to 5.0 years (mean 2.58 years). Seizure outcome, parental assessment of daily function, and parental satisfaction with the outcome was assessed postoperatively. Results. After undergoing 1-stage total callosotomy, drop attacks disappeared completely in 25 patients during the follow-up period, and in 6 patients the frequency of drop attacks decreased to < 10% of baseline. With regard to other types of seizures, seizures resolved completely in 12 patients, and in another 18 seizure frequency decreased. Two patients experienced a transient disconnection syndrome for 2 and 4 weeks. One patient experienced ataxic hemiparesis for 3 weeks before it completely abated. The overall daily function of the patients improved, and all parents were satisfied with the surgical outcome. Conclusions. For pediatric generalized epilepsy syndrome, 1-stage total callosotomy will be the first choice in treatment for controlling generalized seizures.

Original languageEnglish
Pages (from-to)29-36
Number of pages8
JournalJournal of Neurosurgery: Pediatrics
Volume2
Issue number1
DOIs
Publication statusPublished - 2008 Jul

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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