Pichardo-Rojas Diego, Pech-Cervantes Claudio Hiram, Macias-Lopez Jonathan Ulises, Camarena-Rubio Karen Janely, Del Río-Quiñones Manuel Alejandro, Ballesteros-Herrera Daniel, Paredes-Aragon Elma, Hernández-Vanegas Laura Elena, Pichardo-Rojas Pavel S, Mejía-Pérez Sonia Iliana
Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, Mexico.
The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, Texas, USA.
Epilepsia Open. 2025 Aug;10(4):1176-1186. doi: 10.1002/epi4.70082. Epub 2025 Jun 21.
Corpus callosotomy (CC) is a commonly indicated palliative surgery for drug-resistant epilepsy (DRE). While younger age at the time of surgery is a well-established positive prognostic factor, there is limited evidence on long-term outcomes in adult patients with DRE. A study that evaluates seizure control at various follow-up points is necessary to better understand the outcomes of CC.
In this retrospective longitudinal cohort, we included adult CC patients operated on by our institution's epilepsy surgery service between 1993 and 2023. We compiled epilepsy etiology, preoperative seizure frequency, and postoperative seizure outcomes at <1 year of follow-up, 1-3 years of follow-up, and >3 years of follow-up. Our outcomes were seizure freedom and response rate (50% frequency decrease from preoperative).
We analyzed data from 63 patients. The most common indication for CC was DRE due to Lennox-Gastaut Syndrome. Median seizure frequency had a significant decrease from preoperative (70 seizures per month [spm], IQR = 16-210) to the 1 year of follow-up (4 spm, IQR = 0-20, p = <0.0001), 1-3 years of follow-up (8 spm, IQR = 1-30, p = <0.0001), and >3 years of follow-up (7 spm, IQR = 2.25-30, p = <0.0001). Seizure freedom at 1 year postoperative decreased from 25.4% to 10.3% at 1-3 years (p = 0.032), while the overall response rate of our sample remained consistent, being 81% at 1-year follow-up and 70% at the long-term follow-up (p = 0.20). There were 10 postoperative complications, with 5 cases of neurological deficits.
We identified that CC effectively decreases seizure frequency in adult patients with DRE. The reduction of seizure frequency after CC remained consistent after the first postoperative year. Prospective clinical trials are needed to better understand the long-term outcomes of CC in adults.
This study analyzed the outcomes of corpus callosotomy (CC) in adult patients with drug-resistant epilepsy. We identified that CC is a safe and effective long-term treatment, with 70% of patients experiencing significant seizure reduction and 11% achieving seizure freedom. While most existing evidence supports CC in children, our findings support its efficacy in adult patients as well.
胼胝体切开术（CC）是一种常用于耐药性癫痫（DRE）的姑息性手术。虽然手术时年龄较小是一个公认的积极预后因素，但关于成年DRE患者长期预后的证据有限。有必要进行一项评估不同随访点癫痫发作控制情况的研究，以更好地了解CC的治疗效果。
在这项回顾性纵向队列研究中，我们纳入了1993年至2023年间由本机构癫痫手术服务团队进行手术的成年CC患者。我们汇总了癫痫病因、术前癫痫发作频率以及术后<1年随访、1 - 3年随访和>3年随访时的癫痫发作结果。我们的观察指标是癫痫发作缓解和缓解率（发作频率较术前降低50%）。
我们分析了63例患者的数据。CC最常见的适应证是Lennox - Gastaut综合征导致的DRE。癫痫发作中位数频率从术前（每月70次发作[spm]，IQR = 16 - 210）显著下降至1年随访时（4 spm，IQR = 0 - 20，p = <0.0001）、1 - 3年随访时（8 spm，IQR = 1 - 30，p = <0.0001）以及>3年随访时（7 spm，IQR = 2.25 - 30，p = <0.0001）。术后1年癫痫发作缓解率从25.4%降至1 - 3年时的10.3%（p = 0.032），而我们样本的总体缓解率保持一致，1年随访时为81%，长期随访时为70%（p = 0.20）。术后有10例并发症，其中5例出现神经功能缺损。
我们发现CC能有效降低成年DRE患者的癫痫发作频率。术后第一年之后，CC术后癫痫发作频率的降低保持稳定。需要进行前瞻性临床试验以更好地了解CC在成人中的长期预后。
本研究分析了成年耐药性癫痫患者胼胝体切开术（CC）的治疗效果。我们发现CC是一种安全有效的长期治疗方法，70%的患者癫痫发作显著减少，11%的患者实现癫痫发作缓解。虽然大多数现有证据支持CC用于儿童，但我们的研究结果也支持其在成年患者中的疗效。
