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Anterior, Total, and Two‐Stage Corpus Callosum Section: Differential and Incremental Seizure Responses
Author(s) -
Spencer Susan S.,
Spencer Dennis D.,
Sass Kimberlee,
Westerveld Michael,
Katz Amiram,
Mattson Richard
Publication year - 1993
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1993.tb02596.x
Subject(s) - corpus callosotomy , tonic (physiology) , corpus callosum , seizure types , epilepsy , psychology , anesthesia , central nervous system disease , medicine , epilepsy surgery , surgery , neuroscience
Summary: Published reports suggest that control of generalized seizures is improved by callosotomy but do not necessarily indicate that completion of failed anterior callosotomy is beneficial. We studied 42 patients after anterior callosotomy and 22 after total callosotomy, of whom 14 underwent a two‐stage procedure. Cure or marked diminution of seizures was most dramatic for atonic and tonic‐clonic seizures after anterior callosotomy (100 and 83%), and for tonic‐clonic and tonic seizures after total callosotomy (68 and 57%). For the 14 patients who failed to improve after anterior section and then underwent total section, incremental responses were noted for all seizure types, with cure or marked diminution of partial seizures in 2 of 14 patients, of tonic‐clonic seizures in 6 of 10, of tonic seizures in 2 of 4, of atonic seizures in 2 of 5, and of myoclonic seizures in 1 of 1. More than two seizure types, verbal IQ <80, and diffuse ictal EEG patterns were significantly more common in the anterior callosotomy failures. Total callosotomy can be of benefit when anterior callosotomy fails, especially for persistent tonic‐ clonic and tonic seizures, and will most often be necessary in patients with diffuse cerebral abnormalities.