We assessed patterns of drop seizure frequency and seizure types at 3 and 12 months following complete CC and at last follow-up.

Corpus callosotomy (CC) is a palliative surgical procedure that is effective in reducing drop seizures in children with refractory generalized epilepsy.

This was a retrospective, single-institution case series of patients <19 years who underwent complete CC between 2009-2024. Complete CC was achieved by open craniotomy or laser interstitial thermal therapy (LITT). Drop seizures included atonic, tonic, and myoclonic seizures that led to falls. Seizure outcomes were assessed at 3-month, 12-month, and last follow-up. Responders were patients with ≥50% drop seizure reduction compared to pre-CC seizure frequency. McNemar’s test for paired categorical data was performed to evaluate changes in seizure types between 3-month and last follow-up. 

Seventeen patients were included (41% female; median age at epilepsy onset 1 year, IQR 0.5-2.0 and at surgery 10 years, IQR 4-13). Complete CC was performed by open craniotomy in 59% and by LITT in the remaining. Responder rate was 82% at 3-month, 65% at 12-month, and 76% at last follow-up (median follow-up of 4 years, IQR 1-8). Seizure types among 12 patients at 3-month were tonic 58%, atonic 33%, myoclonic 8%, multiple 15.4%. Seizure types among 14 patients were tonic 79%,  atonic 29%, myoclonic 14%, multiple 42.9% at 12-month; tonic 50%, atonic 36%, myoclonic 57%, multiple 37.5% at last follow-up. Although myoclonic seizures and multiple seizure types increased over time, neither reached statistical significance (myoclonic seizures, p=0.06; multiple seizure types p=0.06).