Corpus callosotomy (CC) is a palliative surgical technique classically proposed in patients with drug-resistant epilepsy, particularly those with generalized seizures and drop attacks not remediable by resective surgery. This intervention, when carried out microsurgically, may be associated with a significant rate of complications. CC can be performed incisionless using radiosurgery and, in particular, Gamma Knife surgery (GKS). Current literature shows a fair rate of transient complications but no significant permanent neurological deficit. In our prospective series of 19 patients, the rate of drop attack cessation was 42%, and the rate of complete seizure freedom was 16%. In this intervention, a dose of 55 Gy at the 50% isodose line is applied, covering the anterior two-thirds of the corpus callosum. In case of residual seizures, the CC can be completed by a second-stage GKS targeting the posterior third of the corpus callosum. Due to a similar efficacy and a much lower morbidity and mortality, radiosurgery is a suitable alternative to microsurgical CC.

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Callosotomy by Means of Radiosurgery

  • Jean Régis

摘要

Corpus callosotomy (CC) is a palliative surgical technique classically proposed in patients with drug-resistant epilepsy, particularly those with generalized seizures and drop attacks not remediable by resective surgery. This intervention, when carried out microsurgically, may be associated with a significant rate of complications. CC can be performed incisionless using radiosurgery and, in particular, Gamma Knife surgery (GKS). Current literature shows a fair rate of transient complications but no significant permanent neurological deficit. In our prospective series of 19 patients, the rate of drop attack cessation was 42%, and the rate of complete seizure freedom was 16%. In this intervention, a dose of 55 Gy at the 50% isodose line is applied, covering the anterior two-thirds of the corpus callosum. In case of residual seizures, the CC can be completed by a second-stage GKS targeting the posterior third of the corpus callosum. Due to a similar efficacy and a much lower morbidity and mortality, radiosurgery is a suitable alternative to microsurgical CC.