Anterior two-thirds or complete corpus callosotomy for treatment of medically drug-resistant epilepsy

Abstract

Objective To investigate the extents of corpus callosotomy (CC) resulting in optimal seizure control and compare the efficacies and complications of two CC approaches. Methods Clinical data of 25 patients underwent CC in our hospital from January 2013 to December 2018 were retrospectively analyzed. All 25 patients were diagnosed as having medically refractory epilepsy, and 27 CC procedures were performed. The patients underwent either anterior two thirds CC (n=13) or single-stage complete CC (n=12). Two patients had a second-stage posterior CC in 61 and 36 months after anterior CC, respectively. The efficacies were studied by using two evaluation indexes, the effective rate (worthwhile improvements) and the markedly effective rate (favorable outcomes). Results The average postoperative follow-up time was 2.6 years. In comparison, the markedly effective rate (>75% reduction in seizure frequency or severity) was 71.4% after complete CC and 15.4% after anterior two thirds CC with a statistical significant difference between the two groups (P 50% reduction in seizure frequency or severity) of complete CC (78.6%) was higher than that of anterior two thirds CC (53.8%), but without significant difference (P>0.05). Overall, 66.7% of patients benefited from anterior or complete CC. There were no such complications as intracranial hemorrhage, hydrocephalus, cerebrospinal fluid leakage or postoperative infection. Conclusion Complete CC is more effective for seizure control than anterior two thirds CC; no permanent neurological deficits are observed postoperatively. Key words: Drug-resistant epilepsy; Anterior callosotomy; One-stage total callosotomy