Corpus callosotomy

A palliative therapeutic technique may help identify resectable epileptogenic foci

Dave F. Clarke, James Wheless, Monica M. Chacon, Joshua Breier, Mary Kay Koenig, Mark McManis, Edward Castillo, James E. Baumgartner

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Corpus callosotomy has a long history as a palliative treatment for intractable epilepsy. Identification of a single epileptogenic zone is critical to performing successful resective surgery. We describe three patients in which corpus callosotomy allowed recognition of unapparent seizure foci, leading to subsequent successful resection. We retrospectively reviewed our epilepsy surgery database from 2003 to 2005 for children who had a prior callosotomy and were candidates for focal resection. All underwent magnetic resonance imaging and scalp video electroencephalograph monitoring, and two had magnetoencephalography, electrocorticography and/or intracranial video electroencephalograph monitoring. The children were 8 and 9 years old, and seizure onset varied from early infancy to early childhood. One child had a history of head trauma preceding seizure onset, one had a large intracerebral infarct and dysplastic cortex in the contralateral frontal lobe, and the other had an anterior temporal lobe resection without improvement in seizure frequency. After medical management failed, callosotomy was performed with the expectation of decreasing the seizure types affecting both hemispheres. Following transection of the callosal fibers, a single focus was recognized and resected, with resultant dramatic improvement in seizure control. In medically refractory epilepsy, where rapid secondary bisynchrony is suspected but the electroencephalograph is non-localizing, callosotomy should be considered as a means of treating generalized seizure types, but may also assist in identifying potentially operable seizure foci. Study limitations include its retrospective nature and cohort size. The findings, however, suggest the need for prospective, systematic, well-controlled studies of the use of corpus callostomy in this intractable patient population.

Original languageEnglish (US)
Pages (from-to)545-553
Number of pages9
JournalSeizure
Volume16
Issue number6
DOIs
StatePublished - Sep 1 2007

Fingerprint

Seizures
Therapeutics
Epilepsy
Magnetoencephalography
Corpus Callosum
Frontal Lobe
Temporal Lobe
Scalp
Palliative Care
Craniocerebral Trauma
History
Magnetic Resonance Imaging
Databases
Population

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Clarke, D. F., Wheless, J., Chacon, M. M., Breier, J., Koenig, M. K., McManis, M., ... Baumgartner, J. E. (2007). Corpus callosotomy: A palliative therapeutic technique may help identify resectable epileptogenic foci. Seizure, 16(6), 545-553. https://doi.org/10.1016/j.seizure.2007.04.004

Corpus callosotomy : A palliative therapeutic technique may help identify resectable epileptogenic foci. / Clarke, Dave F.; Wheless, James; Chacon, Monica M.; Breier, Joshua; Koenig, Mary Kay; McManis, Mark; Castillo, Edward; Baumgartner, James E.

In: Seizure, Vol. 16, No. 6, 01.09.2007, p. 545-553.

Research output: Contribution to journalArticle

Clarke, DF, Wheless, J, Chacon, MM, Breier, J, Koenig, MK, McManis, M, Castillo, E & Baumgartner, JE 2007, 'Corpus callosotomy: A palliative therapeutic technique may help identify resectable epileptogenic foci', Seizure, vol. 16, no. 6, pp. 545-553. https://doi.org/10.1016/j.seizure.2007.04.004
Clarke, Dave F. ; Wheless, James ; Chacon, Monica M. ; Breier, Joshua ; Koenig, Mary Kay ; McManis, Mark ; Castillo, Edward ; Baumgartner, James E. / Corpus callosotomy : A palliative therapeutic technique may help identify resectable epileptogenic foci. In: Seizure. 2007 ; Vol. 16, No. 6. pp. 545-553.
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