Seizure outcome after corpus callosotomy: the Taiwan experience

From September 1989 to August 1996, we performed anterior corpus callosotom y in 83 patients. Unfortunately, 9 patients were lost to follow-up. Among t he remaining 74 patients, 59 had Lennox-Gastaut syndrome (evolved from infa ntile spasms in 22), 9 had complex partial seizures with or without seconda ry generalized seizures, 1 had multifocal independent epileptogenic foci (M ISF) syndrome, 3 had hemiconvulsion-hemiplegia-epilepsy (HHE), and 2 had in fantile spasms. All cases were followed up for at least 2 years after surge ry. The highest rate of significant improvement (more than 50% reduction in seizure frequency) was noted in the patients with generalized tonic-clonic seizures, 82.1% of whom experienced significant improvement, followed by t hose with generalized tonic seizures (76.7%), atonic seizures (72.7%), myoc lonic seizures (64.9%), atypical absences (58.6%), and complex partial seiz ure with or without secondary generalization (61.5%). Complete freedom from seizures was noted in 14 cases (18.9%). One patient had the anterior half of his right palm amputated following radial artery thrombosis complicated by insertion of an arterial line during anesthesia. Otherwise, there were n o major postoperative complications except for brief mutism and multifocal jerks in some patients during the Ist postoperative week. Thus, we conclude that corpus callosotomy is a safe alternative treatment for all kinds of m edically intractable seizures, especially generalized epilepsy.