Abstracts

RATIONALE: Patients with non-focal or multifocal epilepsy who have generalized tonic-clonic, tonic, atonic or secondary generalized seizures have been treated with anterior or complete corpus callosotomy. This study was undertaken to evaluate the extend of improved seizure frequency and quality of life. METHODS: 87 patients with the above seizures had a partial or complete corpus callosotomy between 1982 to 1998. Fifteen of these patients also had a frontal lobectomy and were excluded from the study. Pre and postoperative seizure frequency and quality of life were quantified based on reports by the patients and their families. RESULTS: Preoperative demographics included mean age 31 years, 71% never married, 68% unemployed, 69% full scale IQ greater than 70 and 61 patients had an anterior section with 11 having a complete section. Good seizure outcome occurred in 64% of the patients, with 12% Class 1 (seizure free for last year), 12% Class 2 (less than 3 seizures per year) and 40% Class 3 (80% reduction in seizures) at the time of last contact. This success rate was relatively constant over time being 73% at 6 months, 57% at 1 year and 59% at 7 years (n=12). The quality of life improved from 4.5 preop to 7.3 postop (p less than .001). There was one perioperative death, three disconnection syndromes (in complete callosotomy) and one transient hemiparesis. CONCLUSIONS: Corpus callosotomy had a beneficial and lasting effect on seizure frequency and quality of life. This data justifies the expanded use of this procedure.