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Changing the paradigm of 1-stage total callosotomy for the treatment of pediatric generalized epilepsy

Authors
 KYU-WON SHIM  ;  YOUNG-MOK LEE  ;  HEUNG-DONG KIM  ;  JUN-SOO LEE  ;  JOONG-UHN CHOI  ;  DONG-SEOK KIM 
Citation
 JOURNAL OF NEUROSURGERY-PEDIATRICS, Vol.2(1) : 29-36, 2008 
Journal Title
 JOURNAL OF NEUROSURGERY-PEDIATRICS 
ISSN
 1933-0707 
Issue Date
2008
MeSH
Activities of Daily Living ; Age of Onset ; Child ; Child, Preschool ; Corpus Callosum/surgery* ; Electrocardiography ; Epilepsy, Generalized/surgery* ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Neurosurgical Procedures/methods ; Patient Satisfaction ; Prognosis ; Retrospective Studies ; Treatment Outcome
Keywords
Activities of Daily Living ; Age of Onset ; Child ; Child, Preschool ; Corpus Callosum/surgery* ; Electrocardiography ; Epilepsy, Generalized/surgery* ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Neurosurgical Procedures/methods ; Patient Satisfaction ; Prognosis ; Retrospective Studies ; Treatment Outcome
Abstract
OBJECT: The authors propose that anterior callosotomy -- thought to have some advantages over total callosotomy -- is not superior to total callosotomy for prevention of seizure propagation or other complications. METHODS: The study comprised 34 patients in whom generalized epilepsy syndrome or frontal lobe seizures with a secondary generalization were diagnosed. Preoperatively, all patients suffered from disabling drop attacks or intense head-drop seizures, and some patients also experienced other types of seizures. The male/female ratio was 22:12, and patients ranged in age between 1 to 19 years (mean 8.7 years). The follow-up period ranged from 1.08 to 5.0 years (mean 2.58 years). Seizure outcome, parental assessment of daily function, and parental satisfaction with the outcome was assessed postoperatively. RESULTS: After undergoing 1-stage total callosotomy, drop attacks disappeared completely in 25 patients during the follow-up period, and in 6 patients the frequency of drop attacks decreased to < 10% of baseline. With regard to other types of seizures, seizures resolved completely in 12 patients, and in another 18 seizure frequency decreased. Two patients experienced a transient disconnection syndrome for 2 and 4 weeks. One patient experienced ataxic hemiparesis for 3 weeks before it completely abated. The overall daily function of the patients improved, and all parents were satisfied with the surgical outcome. CONCLUSIONS: For pediatric generalized epilepsy syndrome, 1-stage total callosotomy will be the first choice in treatment for controlling generalized seizures.
Full Text
http://thejns.org/doi/abs/10.3171/PED/2008/2/7/029
DOI
10.3171/PED/2008/2/7/029
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Kim, Heung Dong(김흥동) ORCID logo https://orcid.org/0000-0002-8031-7336
Shim, Kyu Won(심규원) ORCID logo https://orcid.org/0000-0002-9441-7354
Lee, Young Mock(이영목) ORCID logo https://orcid.org/0000-0002-5838-249X
Lee, Joon Soo(이준수) ORCID logo https://orcid.org/0000-0001-9036-9343
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107271
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