Authors :
Presenting Author: Diego Pichardo Rojas, MD – Instituto Nacional de Neurología y Neurocirugía
Claudio Pech Cervantes, MD – Instituto Nacional de Neurología y Neurocirugía
Jonathan Macias-Lopez, MD – National Institute of Neurology and Neurosurgery
Elma Paredes-Aragon, MD – National Institute of Neurology and Neurosurgery
Laura Hernandez Vanegas, MD – Instituto Nacional de Neurología y Neurocirugía
Sonia Mejia Perez, MD – Instituto Nacional de Neurología y Neurocirugía
Pavel Pichardo Rojas, MD – University of Texas Health Science Center at Houston
Rationale: Corpus callosotomy (CC) is a commonly indicated palliative surgery for Drug-Resistant Epilepsy (DRE). While younger age at the time of surgery is a well-established positive prognostic factor, there is limited evidence on seizure outcomes in adult patients with DRE. A study that evaluates the efficacy amongst various etiologies of DRE and CC modalities is necessary.
Methods: In this retrospective longitudinal cohort we included patients operated on by the epilepsy surgery service at the National Institute of Neurology and Neurosurgery in Mexico City who had a CC between 1993-2023. We compiled DRE etiology and the type of CC (total or anterior) (Figure 1). Our outcomes were seizure freedom and response rate (50% frequency decrease from preoperative). We performed a logistic regression amongst DRE etiologies and CC modality compared to the resulting outcomes.
Results: We analyzed data from 63 patients with a meadian follow-up of 6 years [IQR=2-11]. The most common indication for CC was DRE due to Lennox-Gastaut Syndrome (n=23), followed by DRE of unknown origin (n=17), and structural DRE (n=13). The rate of seizure freedom was 9.52% (n=6/63), and the response rate was 73.01% (n=46/63) (Figure 1). There were no differences in response rates or seizure freedom rates between different DRE etiologies, and no significant differences in outcomes between anterior and total corpus callosotomy, nor when performing an additional resection to the CC (Figure 2).
Conclusions:
We identified that CC effectively decreases seizure frecuency in adult patients with DRE. Even when presenting as adults, CC remains as an effective treatment option for various etiologies of DRE, similiar outcomes between anterior and total CC, and no proven benefit when performing an additional resection to CC. Prospective clinical trials controlling for external factors, such as medication adherence, are needed to better understand the long-term benefits of CC in adults and other underreported populations.
Funding: Self-funded