Results of anterior corpus callosum section in 24 patients with medically intractable seizures.
Twenty-four medically refractory seizure patients, who did not qualify for excisional surgery, had anterior two-thirds corpus callosum section. Three to 11 years' postoperative follow-up suggests that this procedure can (1) lateralize a frontal lobe focus, which may lead to subsequent localized excision and (2) significantly reduce seizure frequency and severity in 75% of the patients without giving any permanent neurologic deficits. Patients with an ictal focus confined to one frontal lobe did best (8/8 improved), followed by patients with secondarily generalized seizures and multifocal bilateral foci (5/6 improved). Patients with mental retardation benefited less frequently (5/10 improved), but 4/4 from this group with ictal falls associated with Lennox-Gastaut syndrome did benefit. In this series, the improvements following the anterior partial section were lasting if present at 1 year of follow-up. Anterior corpus callosum section should be considered as a diagnostic (lateralizing) and therapeutic option in appropriately defined medically refractory patients who do not qualify for excisional surgery.
Purves
S J
SJ
Division of Neurosciences and Neurology, University of British Columbia, Vancouver, Canada.
Wada
J A
JA
Woodhurst
W B
WB
Moyes
P D
PD
Strauss
E
E
Kosaka
B
B
Li
D
D
D000293:Adolescent; D000328:Adult; D003337:Corpus Callosum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D012640:Seizures / Q000523:psychology / Q000601:surgery*