Open Versus Radiosurgical Corpus callosotomy in Adults with Lennox-Gastaut Syndrome

Saturday, May 4, 2024

2:03 PM – 2:05 PM CT

Location: Booth 745 Neuro Spotlight

Presenting Author(s)

Andrea Garcia Bitar (she/her/hers)

Medical Student
National Institute of Neurology and Neurosurgery "Manuel Velasco Suarez"
CDMX, DF, MX

Co-Author(s)

MA

Mario Arturo Alonso Vanegas, n/a

Neurosurgery
HMG Coyoacán, Distrito Federal, Mexico
CC

Carlos Castillo Montoya, n/a

Neurosurgery
HMG Coyoacán, Distrito Federal, Mexico
OC

Oscar Ruben Contreras Vazquez, n/a

Neurosurgery
Centro Internacional de Cirugía de Epilepsia, Distrito Federal, Mexico
SM

Sergio Moreno Jimenez, Sr., MD, Neurosurgeon

Subdirection of Neurosurgery of the National Institute of Neurology and Neurosurgery
National Institute of Neurology and Neurosurgery, Distrito Federal, Mexico
EQ

Eduardo Quintero Lopez, n/a

Neurosurgery
Centro Internacional de Cirugía de Epilepsia, Distrito Federal, Mexico
IT

Ivan Tapia del Rio, n/a

Neurosurgery
Centro Internacional de Cirugía de Epilepsia, Distrito Federal, Mexico
LZ

Lilian Zavala Romero, n/a

Medical Student
National Institute of Neurology and Neurosurgery, Distrito Federal, Mexico

Disclosure(s):

Andrea Garcia Bitar, n/a: No financial relationships to disclose

Introduction: Lennox-Gastaut-Syndrome (LGS) is a severe epileptic encephalopathy characterized by disabling, drug-resistant seizures.

Methods: 12-year retrospective study which included 34 patients who underwent open approach CC or radiosurgery. Only patients with LGS and a minimum post-operative follow-up of 1-year were included.

Results: Seizure onset was presented on average at 19.4 months of age in both groups. Among all patients, 12 (35%) had a previous diagnosis of West syndrome. Mean age at the time of treatment was 26.5 (ED±7.95) years, with an average of 166.5 seizures per month. Drop attacks were the most disabling type of seizure, followed by generalized tonic and tonic-clonic. MAAV performed the open CC (n=23) and SMJ performed the radiosurgeries (n=11). Seizure reduction was 61.35% vs. 36.27%, 67.96% vs. 45.45%, 77.59% vs. 49.44% and 83.78% vs. 58.18% at 3, 12, 24 and 60 months, respectively. Largest benefit was seen in drop attack seizure control.

Conclusion : Open CC presents better short and long-term results, with significant (p= < 0.001) increase in seizure control when compared to radiosurgery. While radiosurgery requires more time to reach adequate seizure control, it has proven to be a safe and effective alternative. Surgeon expertise is of great benefit, as clinical outcomes depend on it. This study is relevant, as it is the first study comparing open and radiosurgical CC in adult patients with LGS.