A multi‐center comparison of surgical techniques for corpus Callosotomy in pediatric drug‐resistant epilepsy

Bibliographic Details
Title: A multi‐center comparison of surgical techniques for corpus Callosotomy in pediatric drug‐resistant epilepsy
Authors: Daniel Hansen, Sabrina Shandley, Joffre Olaya, Jason Hauptman, Kurtis Auguste, Adam P. Ostendorf, Dewi F. Depositario‐Cabacar, Lily C. Wong‐Kisiel, Shilpa B. Reddy, Michael J. McCormack, Ernesto Gonzalez‐Giraldo, Joseph Sullivan, Javarayee Pradeep, Rani K. Singh, Erin Fedak Romanowski, Nancy A. McNamara, Michael A. Ciliberto, Priya Tatachar, Daniel W. Shrey, Cemal Karakas, Samir Karia, Ammar Kheder, Satyanarayana Gedela, Allyson Alexander, Krista Eschbach, Jeffrey Bolton, Ahmad Marashly, Steven Wolf, Patricia McGoldrick, Srishti Nangia, Zachary Grinspan, Jason Coryell, Debopam Samanta, Dallas Armstrong, M. Scott Perry
Source: Epilepsia. 65:422-429
Publisher Information: Wiley, 2023.
Publication Year: 2023
Subject Terms: Drug Resistant Epilepsy, Epilepsy, 16. Peace & justice, Psychosurgery, Corpus Callosum, 3. Good health, Treatment Outcome, Seizures, Child, Preschool, Humans, Laser Therapy, Child, 10. No inequality, Retrospective Studies
Description: ObjectivesCorpus callosotomy (CC) is used to reduce seizures, primarily in patients with generalized drug‐resistant epilepsy (DRE). The invasive nature of the procedure contributes to underutilization despite its potential superiority to other palliative procedures. The goal of this study was to use a multi‐institutional epilepsy surgery database to characterize the use of CC across participating centers.MethodsData were acquired from the Pediatric Epilepsy Research Consortium (PERC) Surgery Database, a prospective observational study collecting data on children 0–18 years referred for surgical evaluation of DRE across 22 U.S. pediatric epilepsy centers. Patient, epilepsy, and surgical characteristics were collected across multiple CC modalities. Outcomes and complications were recorded and analyzed statistically.ResultsEighty‐three patients undergoing 85 CC procedures at 14 participating epilepsy centers met inclusion criteria. Mean age at seizure onset was 2.3 years (0–9.4); mean age for Phase I evaluation and surgical intervention were 9.45 (.1–20) and 10.46 (.2–20.6) years, respectively. Generalized seizure types were the most common (59%). Complete CC was performed in 88%. The majority of CC procedures (57%) were via open craniotomy, followed by laser interstitial thermal therapy (LiTT) (20%) and mini‐craniotomy/endoscopic (mc/e) (22%). Mean operative times were significantly longer for LiTT, whereas mean estimated blood loss was greater in open cases. Complications occurred in 11 cases (13%) and differed significantly between surgical techniques (p SignificanceCC is an effective surgical modality for children with DRE. Regardless of surgical modality, complication rates are acceptable and seizure outcomes generally favorable. Newer, less‐invasive, surgical approaches may lead to increased adoption of this efficacious therapeutic option for pediatric DRE.
Document Type: Article
Language: English
ISSN: 1528-1167
0013-9580
DOI: 10.1111/epi.17853
Access URL: https://pubmed.ncbi.nlm.nih.gov/38062633
Rights: Wiley Online Library User Agreement
Accession Number: edsair.doi.dedup.....6882faac6c8a723c0c639b72144e8628
Database: OpenAIRE
Description
ISSN:15281167
00139580
DOI:10.1111/epi.17853