Anterior corpus callosotomy in patients with intractable generalized epilepsy and mental retardation

Abstract

Aims: To prospectively study outcomes of anterior corpus callosotomy (aCCT) in patients with refractory generalized epilepsy (RGE) and mental retardation (MR), and estimate the effect of preoperative Wechsler Full Scale Intelligence Quotient (FIQ) on surgical outcomes.

Methods: Selected patients with RGE were divided into a moderate MR group (MoMR), mild MR group (MiMR) and no MR group (NMR), and all of them were treated with aCCT. Seizure outcomes were evaluated at the 1-year follow-up (1FU) and 2-year follow-up (2FU), and changes of quality of life (QOL) and IQ were tested at 2FU.

Results: Seizure control did not differ by group or follow-up period. Most seizure reduction was achieved in atonic or tonic seizures with 76-80% reduction at 1FU and 81-87% at 2FU; myoclonic epilepsy was the least likely to respond. QOL changes differed among groups, and 53.2% of total patients showed postoperative QOL improvement: 75% in the MoMR group, 65% in the MiMR group and 21.1% in the NMR group. No significant group difference was seen in FIQ change, although average postoperative performance IQ (PIQ) improvement in patients with MR exceeded 4 points.

Conclusion: aCCT can reduce seizures and is a safe surgical procedure. Low IQ does not affect seizure outcome and can be associated with a good surgical outcome in PIQ and QOL improvement.