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Instituto Nacional de Neurología y Neurocirugía

2009, Number 3

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Arch Neurocien 2009; 14 (3)

Experience at Hospital Infantil of México Federico Gómez on use of callosotomy for treatment of generalized intractable epilepsy

Castellanos GA, Gordillo DLF, Suástegui RR, Garza MS, Castro-Sierra E, Ponce LFC

Language: Spanish
References: 41
Page: 157-166
PDF size: 126.11 Kb.


ABSTRACT

Callosotomy has been developed to reduce the frequency and severity of intractable epileptic crises. In Mexico, medical centers carrying out surgery of epilepsy in childhood are not yet well developed. In the case of pediatric patients, during the first 6 years after start of crises, it is possible to provide a diagnosis of intractability of epilepsy. This leads one to an early consideration of the surgical procedure of choice before a more marked psychomotor deterioration linked to inadequate control of crises sets in. Taking these facts into consideration, 7 patients with intractable epilepsy and callosotomy were analyzed in order to evaluate efficacy of surgical procedure in control of this disease. Objective: to determine the clinical and EEG features of patients with generalized intractable epilepsy who had submitted to callosotomy. Material and methods: this was a descriptive, retrospective and longitudinal analysis, periodically analyzing patients’ clinical and paraclinical data, and their pre- and post-callosotomy evolution. Results: seven patients with intractable epilepsy and partial callosotomy were studied. A significant decrement of 75% in crisis frequency was observed. There was an 8-year delay in surgical treatment. Concerning type of crisis, there was a decrement in atonic and generalized tonico-clonic types and a persistence of myoclonic and astatic types. Conclusions: the present study’s results agree with other data from the medical literature. A multidisciplinary team, applying study protocols to patients with intractable epilepsy and continuous neuropsychological, social and economic evaluation of them, becomes a requisite when determining the precise moment of cognitive deterioration of patients with risk factors of intractable epilepsy in order to offer an early surgical treatment to them.


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