Corpus callosotomy in children.
BACKGROUND
For children of medical resistant epilepsy without resectable epileptogenic zone, corpus callosotomy and vagus nerve stimulation (VNS) therapy are the two commonly used palliative epilepsy surgeries that can be considered. Although their routes and mechanisms to control epilepsy are different, both surgeries have shown their efficacy in selected candidates. The most common candidates for palliative surgery are in infants and children with organic encephalopathic types of epilepsy including infantile spasms/West syndrome, Lennox-Gastaut syndrome (LGS), severe epilepsy with multiple independent spike foci (SE-MISF) and selected symptomatic partial epilepsy to relief seizures and to stabilize co morbidities (Hirsch and Arzimanoglou, Revue Neurologique [Hirsch E and Arzimanoglou A, Rev Neurol (Paris). 160 Spec No 1:5S210-S219, (2004); Ohtahara S and Yamatogi Y, J Clin Neurophysiol 20(6):398-407, (2003); Wheless JW and Epilepsia 45(Suppl 5):17-22, (2004); Trevathan E, J Child Neurol 17 Suppl 2:2S9-2S22, (2002)].


CONCLUSIONS
Callosotomy is a major and destructive but affordable surgical procedure as compare to the relative simple but costly extracranial procedure of VNS therapy. However, callosotomy is a safe and effective palliative operation in neurosurgeons familiar with the surgical procedure. Equipments for callosotomy can be as simple as headlight and binocular loupes, self-retention brain retractor, bipolar cauterization, and simple microinstruments.
Wong
Tai-Tong
TT
Pediatric Epilepsy Surgery Group, Neurological Institute, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, VACRS, No. 210, Sec 2, Shih-Pai, 11217, Taipei, Taiwan, Republic of China. ttwong@vghtpe.gov.tw
Kwan
Shang-Yeong
SY
Chang
Kai-Ping
KP
Hsiu-Mei
Wu
W
Yang
Tsui-Fen
TF
Chen
Ying-Sheue
YS
Yi-Yen
Lee
L
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003337:Corpus Callosum / Q000601:surgery*; D004599:Electric Stimulation Therapy / Q000379:methods; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D010372:Pediatrics; D012189:Retrospective Studies; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000502:physiology