Anterior callosotomy in the treatment of medically intractable epilepsies: A study of 43 patients with a mean follow-up of 39 months

Authors

  • Hirokazu Oguni MD,

    1. Montreal Neurological Hospital and Institute and the Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
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  • Dr. André Olivier MD, PhD, FRCS(C),

    Corresponding author
    1. Montreal Neurological Hospital and Institute and the Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
    • Montreal Neurological Institute, 3801 University Street, Montreal, PQ, H3A 2B4, Canada
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  • Frederick Andermann MD, FRCS(C),

    1. Montreal Neurological Hospital and Institute and the Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
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  • Joseph Comair MD

    1. Montreal Neurological Hospital and Institute and the Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
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Abstract

We studied the effectiveness of anterior callosotomy in 43 patients whose follow-up period averaged 39 months. These patients had intractable generalized seizures, characterized by a combination of seizure patterns, most frequently drop attacks with generalized tonic-clonic, generalized tonic, and absence seizures. Overall, drop attacks were the most frequent (31/43 or 72%) and the most disabling seizure pattern (27/43 or 63%); they were also the most likely to benefit from anterior callosotomy (70%). Patients with lateralized changes tended to have a better result than did those without lateralization, but patients with synchronous and symmetrical spike and wave discharges also benefited. The preoperative intelligence quotient and the etiological factors were not predictors of outcome. There was a correlation between the extent of section and the results; patients with section of the anterior two thirds had a better result, compared with those who had section of the anterior half.

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