title: Long-term seizure and behavioral outcomes after corpus callosotomy.
abstract: Outcomes of corpus callosotomy (CC) have been mainly focused on seizures. The present study aimed to evaluate the long-term effects of CC on adaptive behaviors and caregivers' satisfaction in addition to seizures and to identify clinical predictors of postsurgical outcomes. Medical records of 26 patients (mean age at study time: 40 years, mean follow-up: 14 years) with childhood-onset epilepsy who underwent anterior or 2-stage complete CC were reviewed. A structured questionnaire was submitted to caregivers asking about relative changes in different seizure types, behavioral functions, and satisfaction with the postoperative outcomes. Formal neuropsychological assessment was carried out in a subgroup of patients. Selected clinical variables including age at surgery, extent of callosal section, length of follow-up, epilepsy syndrome, and presurgical cognitive level were submitted to multiple regression analysis. At the last follow-up visit, a reduction greater than 50% was observed mainly for drop attacks (65% of patients), followed by generalized tonic-clonic seizures (53%), and complex partial seizures (50%). No presurgical variables were significantly associated with seizure outcome. After surgery, more than half of patients showed attention enhancement, which was related to drop seizure improvement. Early age at surgery was associated with better behavioral regulation; complete CC slightly worsened language abilities. Satisfaction with surgery outcomes was expressed by 73% of caregivers and was dependent on drop seizure reduction and improvements in activities of daily living. A long-term positive psychosocial outcome is likely after CC also in severely disabled patients, especially if surgery is performed early.
authors.affiliation: Epilepsy Regional Center, Neurology, Polytechnic University of Marche, Ancona, Italy; Department of Pediatric Neurology, Ospedali Riuniti, Ancona, Italy. Electronic address: claudiapassamonti.psi@gmail.com.
authors.forename: Claudia
authors.initials: C
authors.lastname: Passamonti
authors.affiliation: Department of Pediatric Neurology, Ospedali Riuniti, Ancona, Italy.
authors.forename: Nelia
authors.initials: N
authors.lastname: Zamponi
authors.affiliation: Epilepsy Regional Center, Neurology, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Foschi
authors.affiliation: Department of Neurosurgery, Ospedali Riuniti, Ancona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Trignani
authors.affiliation: Department of Neurosurgery, Ospedali Riuniti, Ancona, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Luzi
authors.affiliation: Department of Pediatric Neurology, Ospedali Riuniti, Ancona, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Cesaroni
authors.affiliation: Epilepsy Regional Center, Neurology, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Leandro
authors.initials: L
authors.lastname: Provinciali
authors.affiliation: Neurosurgery, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Scerrati
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003337:Corpus Callosum / Q000601:surgery*; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adaptive behavior; Corpus callosotomy; Drop attacks; Epilepsy surgery; Parental satisfaction