Abstracts

Rationale: Corpus callosotomy is a proven, safe and effective palliative surgical procedure for patients with medically refractory generalized seizures, specifically in patients with injurious atonic seizures. While some studies have described benefit from this procedure for other generalized seizure types, others have demonstrated poor outcome. The influence of normal versus abnormal imaging findings on seizure outcomes in corpus callosotomy is unclear with studies showing improved outcomes in setting of either of these findings. Our current understanding of outcomes in corpus callosotomy are based on multiple prior studies consisting largely of mixed adult and pediatric cohorts. Herein, we describe one of the largest single center retrospective experience of patients undergoing corpus callosotomy in a pediatric cohort and discuss their seizure outcomes, adverse effects and parental perceptions of this procedure.

Methods: A retrospective review of charts for all patients who underwent corpus callosotomy was done from 2003-2020. Patients were included if they had a minimum of 6 months post-operative follow up. Data collected included age, sex, seizure types pre-and post-callosotomy, seizure reduction post callosotomy, MRI brain, duration of hospital stay and complications (if any).

Results: Forty-one patients were included in the study (29 males). The median duration of epilepsy prior to surgery was 8 years and age at surgery was 10 years. Twenty-five (69%) patients had >50% reduction in atonic seizures (n=36), with 19 (53%) having complete resolution. Fourteen patients (52%) with tonic seizures (n=27), six (60%) with generalized tonic-clonic seizures (n=10), and five (45%) with atypical absences (n=11)- had effective (~50%) reduction in seizure frequency post-operatively. The median duration of hospital stay was 5 days and 51% of the families reported improvement in overall perceived social and functional status. There was no apparent difference in seizure reduction outcomes in patients with normal versus abnormal MRI brain.

Conclusions: Corpus callosotomy is effective in medically refractory epilepsy with atonic seizures as well as other seizure types including generalized tonic-clonic, tonic and atypical absence seizures. The presence of MRI structural abnormality did not influence outcomes in these seizure types.

Funding: Please list any funding that was received in support of this abstract.: N/A.