[P2-106] The efficacy and role of corpus callosotomy for epileptic spasm
[Introduction] Corpus callosotomy (CC) is an established surgery for drop attack and the efficacy has been reported over 80%. In addition to drop attack, CC could also be beneficial for other seizure types such as epileptic spasm (ES), however, the efficacy is not well known. Here, we report our case series of CC performed for ES and discuss its efficacy, surgical complications and factors related to seizure outcome.
[Methodology] CC was performed in 23 cases from July 2014 to June 2016 and all cases were followed up over 6 months. Sixteen cases showing ES as the main seizure type (mean: 7.8, range: 1-15 years) were enrolled in this study. One stage total CC was performed in 14 cases, two-staged total CC and anterior two-third CC was performed in one case each. Seizure outcome was evaluated using Oguni’s classification.
[Results] Ten out of sixteen cases (62.5 %) showed seizure outcome of more than Class C which is a fairly valuable result [Class A (complete seizure free) : 2 case, Class B (> 75% reduction): 2, Class C (50-75% reduction): 6, Class D (< 50% reduction): 6, Class E (aggravation): 0] Complications were epidural hematoma and dysphagia in one case each. Genetic disorders, hypsarrhythmia in preoperative EEG, early onset of ES and bilateral independent spikes in postoperative EEG were noted as negative factors in predicting outcomes.
[Conclusions] Although CC is favorably applied for drop attack as an option for palliative surgery, this study suggests that CC should be considered also for ES.
[Methodology] CC was performed in 23 cases from July 2014 to June 2016 and all cases were followed up over 6 months. Sixteen cases showing ES as the main seizure type (mean: 7.8, range: 1-15 years) were enrolled in this study. One stage total CC was performed in 14 cases, two-staged total CC and anterior two-third CC was performed in one case each. Seizure outcome was evaluated using Oguni’s classification.
[Results] Ten out of sixteen cases (62.5 %) showed seizure outcome of more than Class C which is a fairly valuable result [Class A (complete seizure free) : 2 case, Class B (> 75% reduction): 2, Class C (50-75% reduction): 6, Class D (< 50% reduction): 6, Class E (aggravation): 0] Complications were epidural hematoma and dysphagia in one case each. Genetic disorders, hypsarrhythmia in preoperative EEG, early onset of ES and bilateral independent spikes in postoperative EEG were noted as negative factors in predicting outcomes.
[Conclusions] Although CC is favorably applied for drop attack as an option for palliative surgery, this study suggests that CC should be considered also for ES.