CORPUS CALLOSTOMY IN TREATMENT OF MEDICALLY RESISTANT EPILEPSY - PRELIMINARY-RESULTS IN A PEDIATRIC POPULATION

We report the results of 34 patients who underwent corpus callosotomy between 1986 and 1989 with 28-65 months of postoperative follow-up (me an 42 months). Thirty-two patients had mental retardation and 26 had s ignificant behavioral problems. Thirteen patients had total section, 8 had subtotal section with preservation of the posterior half of the s plenium, and 13 had section of the anterior two thirds of the callosum . Satisfactory seizure control was achieved in 25 patients (73.5%.) At onic seizures, followed by tonic seizures, generalized tonic-clonic se izures (GTCs), and atypical absence seizures were most improved. Myocl onic and complex partial seizures (CPS) did not improve significantly. No deterioration in seizure status was observed postoperatively. Two patients developed previously unobserved simple seizures and CPS posto peratively, but they were not as disabling as the preoperative seizure s. Among the patients with behavioral problems, 81% had significant de crease in aggressiveness, hyperactivity, and/or attention deficit. Pat ients who underwent total section had interhemispheric disconnection s ymptoms that improved progressively and did not interfere with daily l ife. Decreased speech output, dysarthria, and gait dyspraxia occurred after total callosal section and persisted in 5 of the 13 patients. Pa tients who underwent anterior two thirds or subtotal sections did not have such symptoms. Early postoperative complications consisted of ase ptic ventriculitis (5), subdural hematoma (1), and wound infection (4) and resolved without sequelae.