Pecularities of the corpus callosum vascularization for microsurgical callosotomy in patients with severe symptomatic epilepsy

Abstract

Aim . Evaluate of the efficacy and safety of microsurgical callosotomy in the early postoperative period, taking into account the features of the vascularization of the corpus callosum in the surgical treatment of severe symptomatic epilepsy. Material and methods. In study were enrolled 13 children with drug-resistant epilepsy aged from 2 t 16 years (mean 7.3 ± 2.8 years) who underwent callosotomy. At the time of the surgery frequency of seizures was 20.3 ± 9.8 per day, 11 from 13 (84.6%) had repeated status epilepticus. Six (46.2%) had one-stage total callosotomy and 7 (53.8%) underwent anterior callosotomy. Postoperative follow-up was from 8 to 30 moths (mean - 16.7 ± 3.6 months). Results . After surgery 4 (30.8%) were seizure-free (Engel scale – 1), 5 (38.5%) had rare short auras (Engel scale – 2), in 3 (23.0%) cases the seizure frequency significantly reduced – over 80%. In 1 (7.7) child who had Rasmussen encephalitis secondary generalised seizures were stopped but partial motor fits persist (Engel scale – 4). Conclusion . Callosotomy is effective and safe methods of treatment severe epilepsy. Positive outcome is caused by establishing the correct indications for surgery and application of modern microsurgical equipment, taking into account topographic and anatomic features of the blood supply of the corpus callosum.