Faculty Collaboration Database

Corpus Callosotomy or Focal Surgery in Children Presenting With Generalized Tonic Seizures: Findings From the Pediatric Epilepsy Research Consortium. Pediatr Neurol 2026 May;178:170-177

Date

03/20/2026

Pubmed ID

41855704

DOI

10.1016/j.pediatrneurol.2026.02.020

Scopus ID

2-s2.0-105033397443 (requires institutional sign-in at Scopus site)

Abstract

BACKGROUND: To elucidate the clinical profiles and surgical outcomes of patients with generalized tonic seizures (GTSs) undergoing corpus callosotomy (CC) or focal surgery (FS).

METHODS: Subjects with GTS undergoing CC or FS were identified using the Pediatric Epilepsy Research Consortium surgery database. Between-group comparisons were performed to assess differences in presurgical epilepsy characteristics and postsurgical seizure outcomes.

RESULTS: Fifty-four patients (CC: 40 and FS: 14) included. Patients in the CC group had seizure onset at an older age (median = 1 year vs 0.4 years; P = 0.022), and were older at referral for phase-1 evaluation (median = 11.2 years vs 4.85 years; P = 0.026), and at time of surgery (median = 14 years vs 5.6 years; P = 0.008). The CC group showed higher rates of developmental delay (90% vs 57%; P = 0.013) and greater number of antiseizure medications attempted before surgery (median = 6 vs 4; P = 0.049). Electroencephalography localization also differed (P = 0.002), being most commonly generalized (64%, CC group) and multifocal (45%, FS group). Structural magnetic resonance imaging abnormalities were more common in FS group (92% vs 48%, P = 0.008). Median follow-up duration was 13.2 months (interquartile range = 5-24) in the CC group and 13.5 months in the FS group (interquartile range = 8-18). At last follow-up, FS group had a higher rate of seizure freedom (80% vs 19%; P = 0.0006).

CONCLUSIONS: Our findings demonstrate differences in baseline characteristics and postsurgical outcomes of patients with GTS referred for FS and CC. FS yielded high seizure-freedom rates in focal cases. For patients with no discernible seizure focus, CC was often delayed, though outcomes were generally favorable and delays likely unwarranted.

Author List

Karakas C, Warren AEL, Knowles JK, Perry MS, Caraway A, Wong-Kisiel L, Javarayee P, Olaya J, Shrey D, Karia S, Sah J, Ostendorf AP, Tatachar P, Alexander AL, Eschbach K, Bolton J, Reddy SB, McCormack MJ, Singh R, Depositario-Cabacar D, Ciliberto M, Coryell J, Romanowski EF, McNamara N, Giraldo EG, Auguste K, Singhal NS, Clarke DF, PERC Surgery Workgroup and LGS Workgroup

Author

Pradeep Javarayee MBA, MBBS, MD Assistant Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Corpus Callosum
Electroencephalography
Female
Humans
Infant
Male
Neurosurgical Procedures
Seizures
Treatment Outcome