Document Detail


Complete versus anterior two-thirds corpus callosotomy in children: analysis of outcome.
MedLine Citation:
PMID:  20809710     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The goal of this study was to evaluate the efficacy of anterior versus complete sectioning of the corpus callosum in children suffering from medically refractory epilepsy. The authors report seizure outcome in patients who underwent anterior two-thirds or complete corpus callosotomy (CC) during the period 1995-2008 at St. Louis Children's Hospital. METHODS: The medical records of 27 children and adolescents with a minimum follow-up of 6 months were retrospectively evaluated with respect to seizure status, anticonvulsant outcomes, and subjective results. Preoperatively, patients suffered from a variety of seizure types that occurred daily, weekly, or episodically. The male/female ratio was 19:8, and patients ranged in age between 3 and 19 years (mean 9.93 years). Seizure outcome, parental assessment of daily function, and changes in the number of prescribed antiepileptic drugs were all assessed. RESULTS: Fifteen patients underwent an initial anterior two-thirds CC, and 12 underwent a complete CC. Of the 15 patients who underwent an anterior CC, 7 went on to receive a posterior CC. Seizure control was superior in children undergoing a complete CC (91%, Class I-III) versus an anterior two-thirds CC (75%, Class I-III). Seizure types most affected by CC included atonic, myoclonic, and absence. The number of postoperative antiepileptic drugs did not significantly change following CC in either the anterior only or complete groups. One patient experienced a transient disconnection syndrome that resolved within 4 weeks, and 4 patients experienced mild hemiparesis and speech delays that resolved with therapy. Three patients experienced surgical complications requiring a second operation. The overall daily function and attentiveness of the patients improved. CONCLUSIONS: A complete CC should be considered as the initial procedure in lower-functioning children afflicted by absence, atonic, or myoclonic seizures. Severely affected higher-functioning children may also benefit from a complete CC, without clinically significant disconnection syndromes. A completion posterior CC may benefit patients in whom a prior anterior CC has failed.
Authors:
Laleh Jalilian; David D Limbrick; Karen Steger-May; Jim Johnston; Alex K Powers; Matthew D Smyth
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Pediatrics     Volume:  6     ISSN:  1933-0715     ISO Abbreviation:  J Neurosurg Pediatr     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-02     Completed Date:  2010-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101463759     Medline TA:  J Neurosurg Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  257-66     Citation Subset:  IM    
Affiliation:
Washington University in St. Louis School of Medicine, St. Louis, Missouri 63110-1077, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anticonvulsants / administration & dosage
Child
Child, Preschool
Corpus Callosum / surgery*
Epilepsy / surgery*
Female
Follow-Up Studies
Humans
Male
Neurosurgical Procedures / methods
Postoperative Complications
Retrospective Studies
Seizures / surgery
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Anticonvulsants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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