Selective Posterior Corpus Callosotomy for Refractory Drop Seizures
Abstract number :
3.446
Submission category :
9. Surgery / 9A. Adult
Year :
2024
Submission ID :
237
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Amir Arain, MD – University of Utah
Laura Silla, MD – University of Utah
Blake Newman, MD – University of Utah
Sindhu Richards, MD – University of Utah
John Rolston, MD, PhD – Brigham and Women's Hospital, Harvard Medical School
Rationale: Selective posterior callosotomy is used to treat refractory drop seizures (tonic and atonic seizures) while sparing prefrontal interconnectivity, this involves resection of splenium and posterior 50% of corpus callosum. We present our series of six patients that underwent selective posterior corpus callosotomy from 3/2020 to 9/2021.
Methods: Six patients with refractory drop seizures had selective posterior callosotomy and were prospectively followed up for a median of 1.8 years. Baseline drop seizures and GTC seizure frequency was compared to drop seizures and GTC seizure frequency at the last follow up and correlated with demographic, clinical and imaging data.
Results: Five patients had Lennox Gestaut syndrome while the other patient had symptomatic multifocal epilepsy. Four of these patients had failed vagus nerve stimulation (VNS). Median monthly frequency of drop seizures had an 86 % reduction, from 130 before to 18 after the procedure. Two patients had either complete or greater than 92 % control of the drop seizures. Median monthly GTC seizure frequency dropped from 1.5 to 1. Two patients had posterior corpus callostomy with laser ablation. There was a trend towards younger age at surgery with better outcome (p value 0.06). Two patients had no improvement in their seizure frequency after the procedure.
Conclusions: Selective posterior callosotomy is safe and effective to control drop seizures. Laser ablation can be as effective as resection of the posterior corpus callosum. There was a trend towards younger patients having better results with selective posterior corpus callosotomy.
Funding: None
Surgery