Endoscopic-Assisted (Through a Mini Craniotomy) Corpus Callosotomy Combined With Anterior, Hippocampal, and Posterior Commissurotomy in Lennox-Gastaut Syndrome

Abstract

This preliminary study demonstrated the efficacy and safety of complete callosotomy with anterior, hippocampal, and posterior commissurotomy in Lennox-Gastaut syndrome (drop attacks) with moderate to severe mental retardation.

Early recovery of interhemispheric functional connectivity after corpus callosotomy

“…25 Therefore, with appropriate patient selection, combined total callosotomy and commissurotomy may still remain a surgical option. 25 Therefore, with appropriate patient selection, combined total callosotomy and commissurotomy may still remain a surgical option.…”

“…In the patients who presented symptoms with acute disconnection, the symptoms improved within 3-6 months without any motor deficits or permanent deficits. 25 Therefore, with appropriate patient selection, combined total callosotomy and commissurotomy may still remain a surgical option. Nevertheless, long-term follow-up of large cohorts and randomized studies are necessary to better understand the clinical benefits of concomitant commissurotomy.…”

Technical descriptions of four hemispherectomy approaches: From the Pediatric Epilepsy Surgery Meeting at Gothenburg 2014

“…The endoscopic procedure is performed through a transverse skin incision marked over the coronal suture, and a 4 × 3 cm flap raised just lateral to the midline . Neuronavigation is used to mark the exact position of the bone flap and to avoid major draining veins.…”

“…Endoscopic surgery now has a significant application for hemispherotomy, especially with improved optics, better endoscope holders, and neuronavigation techniques …”

“…Rasmussen postulated and later proved that a more limited resection, with disconnection of remaining hemispheric tissue, was as effective in seizure control as the anatomic procedure, but associated with much lower rates of late complications. Rasmussen's approach has been further modified to allow even less tissue removal, with more elegant and less invasive disconnection methods …”