Journal article
A Multi-center Comparison of Surgical Technique for Corpus Callosotomy in Pediatric Drug Resistant Epilepsy
Epilepsia (Copenhagen), Vol.65(2), pp.422-429
02/2024
DOI: 10.1111/epi.17853
PMID: 38062633
Abstract
Corpus callosotomy (CC) is used to reduce seizures, primarily in patients with generalized drug resistant epilepsy (DRE). The invasive nature of the procedure contribute to underutilization despite potential superiority to other palliative procedures. The goal of this study was to use a multi-institutional epilepsy surgery database to characterize the use of CC across participating centers.
Data was acquired from the Pediatric Epilepsy Research Consortium (PERC) Surgery Database, a prospective observational study collecting data on children 0-18 years referred for surgical evaluation of DRE across 22 US pediatric epilepsy centers. Patient, epilepsy, and surgical characteristics were collected across multiple CC modalities. Outcomes and complications were recorded and statistically analyzed.
83 patients undergoing 85 CC procedures at 14 participating epilepsy centers met inclusion criteria. Mean age at seizure onset at 2.3 years (0-9.4), mean age for Phase I evaluation and surgical intervention were 9.45 (0.1-20) and 10.46 (0.2-20.6) years. Generalized seizure types were the most common (59%). Complete CC was performed in 88%. The majority of CC (57%) were via open craniotomy, followed by laser interstitial thermal therapy (LiTT) (20%) and mini-craniotomy/endoscopic (mc/e) (22%). Mean operative times were significantly longer for LiTT while mean estimated blood loss was greater in open cases. Complications occurred in 11 (13%) cases and differed significantly between surgical technique (p <0.001). There was no significant difference in length of post-operative stay across approaches.. Mean follow up was 12.8 months (range 1-39). 37 (78.7%) of the cohort undergoing open craniotomy, 10 (58.8%) LiTT and 12 (63.2%) endoscopic experienced favorable Engel outcomes; which was not statistically different.
CC is an effective surgical modality for children with DRE. Regardless of surgical modality, complication rates are acceptable and seizure outcomes generally favorable. Newer, less invasive, surgical approaches may lead to increased adoption of this efficacious therapeutic option for pediatric DRE.
Details
- Title: Subtitle
- A Multi-center Comparison of Surgical Technique for Corpus Callosotomy in Pediatric Drug Resistant Epilepsy
- Creators
- Daniel Hansen - Cook Children's Medical CenterSabrina Shandley - Cook Children's Medical CenterJoffre Olaya - Children's Hospital of Orange CountyJason Hauptman - Division of Pediatric Neurosurgery, University of Washington/Seattle Children's Hospital, Seattle, WAKurtis Auguste - University of California, San FranciscoAdam P Ostendorf - The Ohio State UniversityDewi F Depositario-Cabacar - George Washington UniversityLily C Wong-Kisiel - Mayo ClinicShilpa B Reddy - Vanderbilt UniversityMichael J McCormack - Vanderbilt UniversityErnesto Gonzalez-Giraldo - University of California, San FranciscoJoseph Sullivan - University of California, San FranciscoPradeep Javarayee - Children's Hospital of WisconsinRani K Singh - Division of Neurology, Department of Pediatrics, Atrium Health/Levine Children's Hospital, Charlotte, NC, USAErin Fedak Romanowski - University of MichiganNancy A McNamara - University of MichiganMichael A Ciliberto - University of IowaPriya Tatachar - Lurie Children's HospitalDaniel W Shrey - Children's Hospital of Orange CountyCemal Karakas - University of LouisvilleSamir Karia - University of LouisvilleAmmar Kheder - Emory UniversitySatyanarayana Gedela - Emory UniversityAllyson Alexander - Children's Hospital ColoradoKrista Eschbach - University of Colorado Anschutz Medical CampusJeffrey Bolton - Boston Children's HospitalAhmad Marashly - Department of Neurology, Johns Hopkins, Baltimore, MDSteven Wolf - Maria Fareri Children's HospitalPatricia McGoldrick - Maria Fareri Children's HospitalSrishti Nangia - Weill Cornell MedicineZachary Grinspan - Weill Cornell MedicineJason Coryell - University of OregonDebopam Samanta - Arkansas Children's HospitalDallas Armstrong - Department of Neurology, University of Texas Southwestern, Dallas, TXM Scott Perry - Cook Children's Medical Center
- Resource Type
- Journal article
- Publication Details
- Epilepsia (Copenhagen), Vol.65(2), pp.422-429
- DOI
- 10.1111/epi.17853
- PMID
- 38062633
- NLM abbreviation
- Epilepsia
- eISSN
- 1528-1167
- Language
- English
- Electronic publication date
- 12/07/2023
- Date published
- 02/2024
- Academic Unit
- Neurology; Stead Family Department of Pediatrics; Neurology (Pediatrics)
- Record Identifier
- 9984528107002771
Metrics
16 Record Views