Staged Total Callosotomy for Lennox-Gastaut Syndrome: A Case Report

We report a case with Lennox-Gastaut syndrome (LGS) who underwent staged total callosotomy with a favorable outcome. A 6-year-old boy began having myoclonic seizures at the age of 8 months and was diagnosed with LGS when he was 27 months old. Various antiepileptic drugs and a ketogenic diet failed to control his multiple types of seizures. At the age of 36 months, he underwent corpus callosotomy and achieved an immediate, post-operative seizure free state. However, 3 months later, various seizures relapsed and were refractory to additional vagus nerve stimulation. Remaining callosal fibers in the splenium noted on post-operative diffusion tensor imaging made us to perform a second operation, total callosotomy. The patient finally achieved a seizure-free state with electroencephalography (EEG) normalization noted after the staged total callosotomy.