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Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
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Completion Corpus Callosotomy with Stereotactic Radiosurgery for Drug-Resistant, Intractable Epilepsy.

Sean Sachdev1, Timothy L Sita1, Nathan A Shlobin2

  • 1Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

World Neurosurgery
|August 23, 2020
PubMed
Summary

Stereotactic radiosurgery (SRS) provides a noninvasive option for corpus callosotomy, effectively controlling atonic seizures in a patient with refractory epilepsy. This palliative intervention demonstrates significant seizure reduction and improved ambulatory function.

Keywords:
Case reportCorpus callosotomyEpilepsyRadiosurgerySeizures

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Epileptology

Background:

  • Stereotactic radiosurgery (SRS) offers a noninvasive method for corpus callosotomy, aiming to improve seizure control in patients with frequent atonic seizures.
  • This palliative approach is suitable for managing refractory epilepsy characterized by rapid interhemispheric generalization.
  • This study reports the first case of radiosurgical completion corpus callosotomy in an adult in the United States.

Observation:

  • A 20-year-old male with Lennox-Gastaut syndrome and refractory epilepsy, who previously underwent an open anterior corpus callosotomy, experienced progressive seizure deterioration.
  • The patient's family opted for SRS corpus callosotomy, which was performed using Gamma Knife technology.
  • The procedure involved delivering 60 Gy to the corpus callosum without complications, and the patient was discharged the following day.

Findings:

  • Eight months post-SRS corpus callosotomy, the patient achieved complete seizure freedom from atonic seizures.
  • The patient regained ambulatory function following the radiosurgical intervention.
  • SRS for completion corpus callosotomy proved effective in controlling refractory seizures.

Implications:

  • Radiosurgical completion corpus callosotomy is a viable and effective treatment option for carefully selected patients with refractory epilepsy.
  • This noninvasive technique offers a promising alternative for seizure management when traditional methods have failed.
  • Further research into SRS for epilepsy surgery may expand its application in neurological practice.