Introduction: Minimally-invasive, laser interstitial thermal therapy (LITT) for corpus callosotomy has been reported previously in a few patients with intractable epilepsy but reports of methods and clinical outcomes remains sparse. In the pediatric population, only one such case is reported with achievement of Engel III outcome. We present, to our knowledge, only the second detailed pediatric case using LITT for corpus callosotomy and the only one to achieve a seizure-free outcome.

Methods: The patient is an 11-year-old girl with Lennox-Gastaut syndrome after contracting HSV encephalitis at 8 months of age. Her seizure semiology included daily head drop and atonic seizures that were uncontrolled on multiple anti-epileptic medications. Using LITT, she underwent corpus callosotomy of rostrum through the body sparing only the splenium.

Results: Her immediate post-operative course complicated only by one week of abulia. At four months post-operatively, she was free of clinical seizures and was weaned off one of her anti-seizure medications.

Conclusions: Use of LITT obviously provides a less invasive alternative to the open corpus callosotomy, and if effective, LITT presents a powerful alternative to the open approach. From the handful of available reports, we present the most extensive corpus callosotomy using LITT, and the only pediatric patient free of clinical seizures post-operatively.

Patient Care: This report provides evidence for a less invasive alternative to open corpus callosotomy that is safe and effective.

Learning Objectives: Participants will be able to identify a non-invasive approach to corpus callosotomy that is safe and effective in treating medically refractory epilepsy in pediatric patient.

References: Ho AL, Miller KJ, Cartmell S, Inoyama K, Fisher RS, Halpern CH. Stereotactic laser ablation of the splenium for intractable epilepsy. Epilepsy Behav Case Rep. 2016 Jan 13;5:23-6. Tao JX, Issa NP, Wu S, Rose S, Collins J, Warnke PC. Interstitial Stereotactic Laser Anterior Corpus Callosotomy: A Report of 2 Cases with Operative Technique and Effectiveness. Neurosurgery. 2018 Jul 5. North RY, Raskin JS, Curry DJ. MRI-Guided Laser Interstitial Thermal Therapy for Epilepsy. Neurosurg Clin N Am. 2017 Oct;28(4):545-557.