Abstracts

Rationale: Radiosurgical corpus callosotomy is a new non-invasive, palliative, apparently safe and successful option to achieve control in drug-resistant severe epilepsy that involves drop attacks. However there are no studies that compare efficacy and safety of this technique compared to surgical corpus callosotomy. This study objective is to describe and compare the clinical variables, safety, efficacy, electroencephalographic and neuroimaging features that impact on the prognosis in both of the techniquesMethods: Retrospective analysis (2004-2011) of patients who underwent either radiosurgical corpus callosotomy (RC) or surgical corpus callosotomy (SC) was performed. Clinical, neurophysiological, neuroimaging and follow up variants were obtained and analyzed using descriptive statistics (means and standard deviations) as well as Fisher s exact test for paired groupsResults: 18 subjects were included 9 [7 males] in SC and 9 [3 males] in RC. The average age at time of surgery was 21.3 9.08 years in RC and 25.5 7.97 in SC. Average time to diagnosis was 2.04 2.30y in RC and 3.14 2.92y in SC. 17 out of 18 subjects (94%) were diagnosed with cryptogenic Lennox-Gastaut Syndrome and multi-focal epileptic activity. To perform the surgery in the RC group a mean dose of 40.88Gy ( 2.66) were used. Follow-up was performed at 10.3 ( 6.4) months. There was a decline in monthly seizure frequency for RC (-66.6%) as well as for SC (-71.1%) with no significant difference between them (p=0.064). Tonic and Atonic seizures were the most reduced in both groups. In RC 3 subjects presented with complications; 2 with severe cerebral edema and 1 entered non-convulsive status epilepticus. There were no complications reported on SC.Conclusions: Radiosurgical corpus callosotomy shows similar efficacy compared with surgical corpus callosotomy in reducing crisis frequency in subjects with drug-resistant epilepsy that involves drop-attacks. Even though there is a major incidence of complications in the RC group. More prospective alleatory studies with a larger study population are required to confirm this finding.