Abstracts

RATIONALE: Epilepsy surgery has been a resource with increasing acceptance in developing countries as a valuable resource for intractable epilepsy. Complete corpus callosotomy is an effective procedure to treat the central bilateral synchrony associated with atonic seizures. The procedure is usually done involving the anterior two thirds of the corpus callosum, and the side effects include the well-known disconnection syndrome.
To identify the cases were the procedure was done in a complete fashion, and review the indications and the neurophysiologic findings that motivated this type of surgery at an early age.
METHODS: The sample included the patients that were operated with a complete corpus callosotomy for intractable seizures. All the patients had preoperative video telemetry and MRI of the brain. In all cases the procedure was done to alleviate head and truncal atonic seizures. Whenever other types of seizures were identified, they were always in a ratio of less than 8:1. All patients had a history of more than 10 seizures per day. The cases with a metabolic or degenerative disease were excluded.
RESULTS: Out of a population of 15 patients with corpus callosotomies we included the ones with a complete section and no additional epilepsy surgery procedures such as corticectomy, performed, 3 patients were therefore enrolled. The mean age was 5 years. The seizure focus in all cases was located posteriorly, either posterior temporal/parietal or occipital. All cases developed a disconnection syndrome that included a right-left incoordination that eventually improved within the next 10 days following the procedure. The follow up was for at least 6 months in all cases the seizure free outcome was above 90 percent.
CONCLUSIONS: Complete callosotomy is a valuable procedure for patients with intractable atonic seizures of posterior origin, the disconnection syndrome that typically occurs in older patients has a shorter duration and better recovery in early ages.