Corpus Callosotomy with Radiosurgery

Corpus Callosotomy with Radiosurgery AbstractOBJECTIVE:Corpus callosotomy is a surgical option for medically uncontrolled generalized epilepsy in appropriate patients. Because numerous complications related to open callosotomy are still reported, we performed radio- surgical corpus callosotomy with the gamma knife.METHODS:Between October 1992 and June 1995, three patients underwent stereotactic radiosurgery to ablate the anterior third of the corpus callosum. The patients had intractable epilepsy: two had Lennox-Gastaut syndrome, and one had multifocal epilepsy with atonic, tonicoclonic, and atypical absence seizures. The history of seizures ranged from 20 to 37 years' duration. Stereotactic radiosurgery was performed with a cobalt-60 gamma knife using a 4-mm collimator, targeted to the rostrum, genu, and anterior third of body of the corpus callosum. Two patients were treated once with 150 and 160 Gy at maximum, respectively, and one patient was treated in two stages with 50 Gy and then 170 Gy at maximum.RESULTS:The severity and frequency of seizures were significantly reduced in all three patients. The types of seizures associated with the most improved outcome were atonic and generalized tonicoclonic seizures. The mean follow-up period was 38 months. Hospitalization required for this procedure was 3 days. No complications related to irradiation were recorded except transient headache in one patient.CONCLUSION:The outcomes suggest that radiosurgical corpus callosotomy may be a promising alternative treatment to open callosotomy. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Corpus Callosotomy with Radiosurgery

Corpus Callosotomy with Radiosurgery

Gerhard Pencil, M.D., Hans G. Eder, M.D., Oskar Schroettner, M.D., Klaus A. Leber, M.D. Department of Neurosurgery, Karl-Franzens University, Graz, Austria OBJECTIVE: Corpus callosotomy is a surgical option for medically uncontrolled generalized epilepsy in appropriate patients. Because numerous complications related to open callosotomy are still reported, we performed radio- surgical corpus callosotomy with the gamma knife. METHODS: Between O ctober 1992 and June 1995, three patients underwent stereotactic radiosurgery to ablate the anterior third of the corpus callosum. The patients had intractable epilepsy: two had Lennox-Gastaut syndrome, and one had multifocal epilepsy with atonic, tonicoclonic, and atypical absence seizures. The history of seizures ranged from 20 to 37 years' duration. Stereotactic radiosurgery was performed with a cobalt-60 gamma knife using a 4-mm collim ator, targeted to the rostrum, genu, and anterior third of body of the corpus callosum. Two patients were treated once with 150 and 160 Gy at maximum, respectively, and one patient was treated in two stages with 50 Gy and then 170 Gy at maximum. RESULTS: The severity and frequency of seizures were significantly reduced in all three patients. The types of seizures associated with the most improved outcome were atonic and generalized tonicoclonic seizures. The mean follow-up period was 38 months. Hospitalization required for this procedure was 3 days. No complications related to irradiation were recorded except transient headache in one patient. CONCLUSION: The outcomes suggest that radiosurgical corpus callosotomy may be a promising alternative treatment to open callosotomy. (Neurosurgery 45:303-308, 1999) Keywords: Corpus callosotomy, Epilepsy, Gamma knife, Radiosurgery administration of maximal medical treatment for more than 2 n patients with medically intractable epilepsy who are not years failed to control their seizures. The duration of epilepsy candidates for focal resections,...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199908000-00021
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:Corpus callosotomy is a surgical option for medically uncontrolled generalized epilepsy in appropriate patients. Because numerous complications related to open callosotomy are still reported, we performed radio- surgical corpus callosotomy with the gamma knife.METHODS:Between October 1992 and June 1995, three patients underwent stereotactic radiosurgery to ablate the anterior third of the corpus callosum. The patients had intractable epilepsy: two had Lennox-Gastaut syndrome, and one had multifocal epilepsy with atonic, tonicoclonic, and atypical absence seizures. The history of seizures ranged from 20 to 37 years' duration. Stereotactic radiosurgery was performed with a cobalt-60 gamma knife using a 4-mm collimator, targeted to the rostrum, genu, and anterior third of body of the corpus callosum. Two patients were treated once with 150 and 160 Gy at maximum, respectively, and one patient was treated in two stages with 50 Gy and then 170 Gy at maximum.RESULTS:The severity and frequency of seizures were significantly reduced in all three patients. The types of seizures associated with the most improved outcome were atonic and generalized tonicoclonic seizures. The mean follow-up period was 38 months. Hospitalization required for this procedure was 3 days. No complications related to irradiation were recorded except transient headache in one patient.CONCLUSION:The outcomes suggest that radiosurgical corpus callosotomy may be a promising alternative treatment to open callosotomy.

Journal

NeurosurgeryOxford University Press

Published: Aug 1, 1999

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