The clinical features of patients with seizure freedom and failure after total corpus callosotomy for childhood-onset refractory epilepsy

Abstract

Background

Corpus callosotomy is a palliative surgery for medically refractory epilepsy. We aim to analyze the clinical features of patients with seizure freedom and failure after total corpus callosotomy for childhood-onset refractory epilepsy.

Methods

We retrospectively reviewed the clinical courses of patients with childhood-onset refractory epilepsy undergoing total corpus callosotomy between May 2009 and March 2019. Seizure outcome at the last follow-up was the primary outcome. The clinical features of patients with seizure freedom and failure after callosotomy were compared.

Results

Eighty patients with childhood-onset refractory epilepsy underwent total corpus callosotomy; 15 (18.8%) obtained freedom from all seizures and 19 (23.8%) had unworthwhile improvement and failure. The mean ages at seizure onset in patients with seizure freedom and failure after callosotomy were 5.7 and 5.9 years; and mean seizure durations were 9.4 and 11.5 years, respectively. Univariate analysis found epilepsy syndrome (p = 0.047), mental retardation (p = 0.007), previous medical history (p = 0.004), ≥10 seizures per day (p = 0.024), theta waves in the background electroencephalogram (p = 0.024), and acute postoperative seizure (p = 0.000) were associated with failure after callosotomy. Seizure freedom after callosotomy was more common among patients with less than 10 seizures per day.

Conclusions

Total corpus callosotomy is an effective palliative procedure for childhood-onset refractory epilepsy, particularly for patients with specific clinical characteristics. Callosotomy has a high seizure-free rate in well-selected patients.

Keywords:

• Childhood
• refractory epilepsy
• corpus callosotomy
• seizure freedom
• failure

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee of the First Affiliated Hospital of Xi’an Jiaotong University and with the 1964 Helsinki declaration and its later amendments. Informed consent was waived due to this retrospective study.

Acknowledgement

We thank the patients undergoing CC, the proxies taking good care of them, and the physicians for the referral to our surgical center.

Disclosure statement

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China (NO. 82101524), Innovation Capability Support Program of Shaanxi (NO. 2021LCZX-01), Natural Science Basic Research Program of Shaanxi (NO. 2021JQ-384, 2021SF-083, and 2022JQ-809), and the Institutional Foundation of the First Affiliated Hospital of Xi’an Jiaotong University (NO. 2020ZYTS-01).