Posterior Selective Callosotomy: A Case Series
Servin Moreno Oscar, MD* 1,2, Varela-Osorio, MD1,3, Gomes Luiz Pedro, MD1,4, Ordoñez Jorge, MD1,3, Vieira Samuel, MD1
and Silva Centeno Ricardo, PhD1
1Federal University of São Paulo, Paulista School of Medicine, Sao Paulo Hospital, Department of Functional Neurosurgery, Sao Paulo, Brazil
2Instituto de Previsión Social – Hospital Central, Neurosurgery Service, Asunción, Paraguay.
3Neurological Institute of the Pacific, Epilepsy Surgery Service, Cali, Colombia.
4 Souza Aguiar Municipal Hospital, Neurosurgery Service, Rio de Janeiro, Brazil
*Corresponding Author: Dr. Servin Moreno Oscar, MD, Federal University of São Paulo, Paulista School of Medicine, Sao Paulo Hospital, Department of Functional Neurosurgery, Sao Paulo, Brazil.
Received: February 19, 2022 Published: February 28, 2022
Abstract
Refractory epilepsies are associated with sudden bilateral synchronization Ictal, which supports the justification for a callosotomy. The indication of posterior callosotomy was recommended in individuals with Lennox Gastaut syndrome and Drop-Attacks type crises. Used a technique of interhemispheric approach parieto-occipital, in Fowler position, with a minimum rupture of fibers. For the demonstration of the cases submitted to this technique, we seek to follow the following objectives: 1. Describe the history of the different Callosotomy techniques, 2. Describe the first four cases of callosotomy via the service, using case reports, which consisted of the description of 4 cases submitted to the surgical procedure. Compared to the pre-surgical state, case 1 decreased from 100 seizures/day to 6 crises/day for other crises and from 14 crises/day to 1 crisis/day for Drop-Attacks. Already in case 2 a reduction of 7 crises/day was obtained to 0.14 crisis/day, which gives us a value of 1 crisis per week for other crises and from 3 crisis/day to 0 crisis/day for Drop Attacks, in case number 3 a decrease of 70 crises/day to 5 crises/day was observed for other crises and for Drop-Attacks type crises from 5 crisis/day to 0 crisis/day, in case 4 a reduction from 80 crises/day to 0.57 crises/day, which gives us a value of 4 crises per week and from 20 crises/day to 0 crises/day for Drop-Attacks type crises. Given the data exposed and the alteration of cognition we can say that in these cases a significant improvement in the quality of life of all patients was observed. This technique brings with it some advantages in relation to others used in the past, mainly related to the anatomy of the approach, the most favorable with respect to this is the interhemispheric fissure of the posterior region. The results are similar in seizure control and with potential advantage in cognitive preservation, although in our series we did not have an ideal sample for this last analysis, since all patients had a severe neuropsychomotor delay before surgery.
Keywords: Epilepsy, Posterior callosotomy, surgical technique
Citation: Oscar SM, Osorio V, Pedro GL, Jorge O, Samuel V, Ricardo SC . “Posterior Selective Callosotomy: A Case Series”. SVOA Neurology 3:2 (2022) Pages 51-60.
