Endoscopic callosotomy as a minimally invasive approach to treat paediatric refractory epilepsy: case series

Childs Nerv Syst. 2024 Jun;40(6):1807-1811. doi: 10.1007/s00381-024-06319-6. Epub 2024 Feb 14.

Abstract

Background: Endoscopic callosotomy has emerged as a promising and minimally invasive technique for the treatment of refractory epilepsy. This paper aims to review the clinical outcomes and advancements associated with endoscopic callosotomy as a therapeutic option.

Materials and methods: This study includes 14 Paediatric patients diagnosed and managed at Al-azhar university hospitals. Those 14 patients were studied over 2 years. All patients underwent a corpus callosotomy using the bimanual endoscopic technique.

Results: Endoscopic anterior corpus callosotomy was done in 13 patients while one case underwent endoscopic complete callosotomy. The most frequent complication was transient disconnection syndrome followed by transient Urinary incontinence and one case had minor CSF leak. As regard seizure freedom outcome (Engel's Outcome Scale): 4 cases (28.6%) became seizure free (Engle class I), 5 cases (35.7%) with Engle class II, 1 case (7.1%) with Engle class III and 4 cases (28.6%) classify as Engle class IV.

Conclusion: As a minimally invasive technique with a favorable impact on cognitive function, less complications and a significant reduction in seizure frequency and severity in the majority of paediatric patients, endoscopic corpus callosotomy offeres substantial benefits in managing refractory epilepsy in paediatric.

Keywords: Callosotomy; Disconnection; Endoscopic; Epilepsy and Engle.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Corpus Callosum* / surgery
  • Drug Resistant Epilepsy* / surgery
  • Endoscopy / methods
  • Female
  • Humans
  • Male
  • Minimally Invasive Surgical Procedures* / methods
  • Neuroendoscopy* / methods
  • Retrospective Studies
  • Treatment Outcome