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Corpus callosotomy for drug-resistant spasms associated with tuberous sclerosis complex
Tohru Okanishi1, Ayataka Fujimoto2, Kazuo Okanari3
1Department of Child Neurology, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan.
Corpus callosotomy (CC) effectively treated drug-resistant spasms in tuberous sclerosis complex (TSC) patients. Some patients achieved remission with CC alone, while others benefited from additional surgical interventions for improved seizure control.
Area of Science:
- Neurology
- Neurosurgery
- Epileptology
Background:
- Corpus callosotomy (CC) is increasingly used for drug-resistant epileptic and tonic spasms.
- Tuberous sclerosis complex (TSC) is a genetic disorder associated with epilepsy.
Purpose of the Study:
- To investigate the outcomes of corpus callosotomy (CC) in patients with drug-resistant epileptic or tonic spasms secondary to tuberous sclerosis complex (TSC).
Main Methods:
- Retrospective data collection from seven TSC patients who underwent CC.
- Analysis of seizure types (epileptic spasms, tonic spasms) confirmed by video-electroencephalogram.
- Evaluation of outcomes following total CC, with some patients receiving additional surgical procedures.
Main Results:
- Three out of seven patients achieved complete remission of spasms after CC alone.
- Two patients experienced spasm freedom after CC plus additional surgery or medical treatment.
- Two patients continued to experience spasms or asymmetrical tonic seizures post-CC.
Conclusions:
- Total corpus callosotomy (CC) can lead to freedom from drug-resistant spasms in some TSC patients.
- A stepwise surgical approach, including CC followed by further resection or disconnection, may improve spasm management in TSC.
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