Favorable outcome of corpus callosotomy is reported in pediatric population with intractable epilepsy and it is considered standard of care for patients with drop attacks.
Our objective is to compare the long term outcome of corpus callosotomy for drug resistant epilepsy in adult population.
Corpus callosotomy is a palliative neurosurgical procedure for patients with medically drug-resistant epilepsy who are not candidates for resective epilepsy surgery. Corpus callosotomy is most commonly performed in children with epilepsy, either as an anterior two-thirds disconnection of corpus callosum or as a complete disconnection. Good long-term outcomes against drop attacks have been reported in a population-based prospective study and the risk of a persistent complication is low.
17 adults with idiopathic generalized epilepsy, frontal lobe epilepsy and Lennox Gastaut Syndrome (LGS) were followed for the outcome measures of seizure and antiepileptic drug (AED) burden and quality of life (QoL).
Data was extracted from patients registered in our RedCap database.
17 patients fulfill the inclusion criteria. 4 underwent conventional corpus callsotomy and 14 had laser interstitial thermal therapy (LITT). 7 had failed prior Vagal Nerve Stimulator and 10 did not have VNS.
All patients who had conventional procedure had complications and none from the LITT group reported complications. 11 patients reported presence of seizures and 6 were seizure free. None of the patients had persistent drop attacks, while 4 had convulsive seizures and 11 had mild focal impaired awareness seizures. More than 70 % of the patients reported improvement in speech, social abilities and activities of daily living.
Corpus callosotomy for drug resistant epilepsy in adults provide significant improvement when observed for decreasing in seizure burden, reduction in medication and improvement of quality of life.
LITT carries a low risk for complication and similar efficacy when compared with conventional one and should be utilize more frequently.