{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:00:37Z","timestamp":1790391637653,"version":"4.1.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,7]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the prognostic value of intraoperative EEG during corpus callosotomy (CC) in pediatric patients with drug-resistant epilepsy (DRE), with a particular focus on bisynchronization blockade and its correlation with long-term seizure outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective review was performed of pediatric patients with DRE and injurious drop attacks who underwent CC between 2005 and 2024. Patients were stratified into three groups based on intraoperative scalp EEG findings: 1) &gt; 50% bisynchronization blockade, 2) &lt; 50% blockade, and 3) absent bisynchronization. Baseline clinical characteristics, surgical approach, and extent of CC were recorded. Seizure outcomes were assessed using Engel and International League Against Epilepsy (ILAE) classifications with a minimum follow-up of 1 year. Whether atonic seizures resolved postoperatively was also evaluated. Group comparisons were performed using Fisher\u2019s exact test and Kruskal-Wallis rank-sum testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Forty-six patients met the inclusion criteria. The majority underwent complete CC (65%), most via an open approach (67%). At 1 year, freedom from atonic seizures (ILAE class 1Engel class I) was highest in the &gt; 50% blockade group (70.0%) compared with the &lt; 50% blockade (40.0%) and absent bisynchronization (25%) groups (p = 0.042). At last follow-up (mean 5.3 years), the &gt; 50% blockade group similarly achieved significantly higher rates of atonic seizure freedom (ILAE class 1\/Engel class I, 76%) compared with 0% in the &lt; 50% blockade and 25% in the absent bisynchronization groups (p &lt; 0.001). Outcomes for total seizure freedom varied and did not reach statistical significance between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Achieving &gt; 50% intraoperative bisynchronization blockade during CC was strongly associated with improved long-term atonic seizure freedom. These findings support the role of intraoperative EEG as a prognostic marker of effective seizure control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.4.peds2682","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:01:41Z","timestamp":1785888101000},"page":"1-7","source":"Crossref","is-referenced-by-count":0,"title":["The association between the degree of intraoperative bisynchronization blockade and drop attack freedom after corpus callosotomy in pediatric patients: a comparative cohort study"],"prefix":"10.3171","author":[{"given":"Jeffrey P.","family":"Turnbull","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Michigan State University College of Human Medicine, Henry Ford Providence Hospital, Southfield, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Griepp","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Michigan State University College of Human Medicine, Henry Ford Providence Hospital, Southfield, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Michigan State University College of Human Medicine, Henry Ford Providence Hospital, Southfield, Michigan;"},{"name":"Oklahoma State University, College of Medicine, Tulsa, Oklahoma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Caskey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Michigan State University College of Human Medicine, Henry Ford Providence Hospital, Southfield, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivum","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Michigan State University College of Human Medicine, Henry Ford Providence Hospital, Southfield, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander I.","family":"Helfand","sequence":"additional","affiliation":[{"name":"Department of Neurology, Michigan State University College of Osteopathic Medicine, Henry Ford Health System, Detroit;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna T. K.","family":"Griepp","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Michigan State University College of Human Medicine, Henry Ford Providence Hospital, Southfield, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Heitkotter","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Michigan State University College of Human Medicine, Henry Ford Providence Hospital, Southfield, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neena I.","family":"Marupudi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Michigan Medicine, Mott Children\u2019s Hospital, Ann Arbor;"},{"name":"Department of Neurosurgery, Wayne State University School of Medicine, Children\u2019s Hospital of Michigan, Detroit;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wayne State University School of Medicine, Children\u2019s Hospital of Michigan, Detroit;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eishi","family":"Asano","sequence":"additional","affiliation":[{"name":"Department of Neurology, Wayne State University School of Medicine, Children\u2019s Hospital of Michigan, Detroit; and"},{"name":"Department of Pediatrics, Wayne State University School of Medicine, Children\u2019s Hospital of Michigan, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Cools","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wayne State University School of Medicine, Children\u2019s Hospital of Michigan, Detroit;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"10","key":"b1","series-title":"N Engl J Med","first-page":"919","article-title":"Drug-resistant epilepsy","volume":"365","author":"Kwan P","year":"2011","unstructured":"Kwan P, Schachter SC, Brodie MJ. Drug-resistant epilepsy. N Engl J Med. 2011;365(10):919\u2013926. doi:10.1056\/NEJMra1004418"},{"key":"b2","series-title":"Neuropsychiatr Dis Treat","first-page":"2605","article-title":"Managing drug-resistant epilepsy: challenges and solutions","volume":"12","author":"Dalic L","year":"2016","unstructured":"Dalic L, Cook MJ. Managing drug-resistant epilepsy: challenges and solutions. Neuropsychiatr Dis Treat. 2016;12:2605\u20132616. doi:10.2147\/NDT.S84852"},{"key":"b3","series-title":"Seizure","first-page":"17","article-title":"The pharmacological management of Lennox-Gastaut syndrome and critical literature review","volume":"63","author":"Verrotti A","year":"2018","unstructured":"Verrotti A, Striano P, Iapadre G,  The pharmacological management of Lennox-Gastaut syndrome and critical literature review. Seizure. 2018;63:17\u201325. doi:10.1016\/j.seizure.2018.10.016"},{"issue":"17","key":"b4","series-title":"N Engl J Med","first-page":"1639","article-title":"Surgery for drug-resistant epilepsy in children","volume":"377","author":"Dwivedi R","year":"2017","unstructured":"Dwivedi R, Ramanujam B, Chandra PS,  Surgery for drug-resistant epilepsy in children. N Engl J Med. 2017;377(17):1639\u20131647. doi:10.1056\/NEJMoa1615335"},{"key":"b5","series-title":"World Neurosurg","first-page":"69","article-title":"Complete corpus callosotomy for refractory epilepsy in children","volume":"164","author":"Barrit S","year":"2022","unstructured":"Barrit S, Park EH, El Hadwe S, Madsen JR. Complete corpus callosotomy for refractory epilepsy in children. World Neurosurg. 2022;164:69. doi:10.1016\/j.wneu.2022.04.099"},{"key":"b6","series-title":"Seizure","first-page":"34","article-title":"Complete callosotomy in children with drop attacks; a retrospective monocentric study of 50 patients","volume":"96","author":"Ferrand-Sorbets S","year":"2022","unstructured":"Ferrand-Sorbets S, Fohlen M, Bourdillon P,  Complete callosotomy in children with drop attacks; a retrospective monocentric study of 50 patients. Seizure. 2022;96:34\u201342. doi:10.1016\/j.seizure.2022.01.008"},{"issue":"6","key":"b7","series-title":"Neurosurgery","first-page":"993","article-title":"Seizure outcomes after corpus callosotomy for drop attacks","volume":"73","author":"Bower RS","year":"2013","unstructured":"Bower RS, Wirrell E, Nwojo M, Wetjen NM, Marsh WR, Meyer FB. Seizure outcomes after corpus callosotomy for drop attacks. 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Corpus callosotomy for intractable epilepsy in the pediatric population: value of intraoperative neurophysiological monitoring. Childs Nerv Syst. 2025;41(1):123. doi:10.1007\/s00381-025-06773-w"},{"issue":"1","key":"b10","series-title":"Epilepsia","first-page":"74","article-title":"Value of intraoperative EEG changes during corpus callosotomy in predicting surgical results","volume":"34","author":"Fiol ME","year":"1993","unstructured":"Fiol ME, Gates JR, Mireles R, Maxwell RE, Erickson DM. Value of intraoperative EEG changes during corpus callosotomy in predicting surgical results. Epilepsia. 1993;34(1):74\u201378. doi:10.1111\/j.1528-1157.1993.tb02378.x"},{"issue":"7","key":"b11","series-title":"Seizure","first-page":"470","article-title":"Prognostic value of electrocorticography findings during callosotomy in children with Lennox\u2013Gastaut syndrome","volume":"14","author":"Kwan SY","year":"2005","unstructured":"Kwan SY, Lin JH, Wong TT, Chang KP, Yiu CH. 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Clin Neurophysiol. 2013;124(11):2091\u20132100. doi:10.1016\/j.clinph.2013.05.004"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2026.4.PEDS2682\/article-10.3171-2026.4.PEDS2682.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2026.4.PEDS2682\/article-10.3171-2026.4.PEDS2682.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:19:48Z","timestamp":1790389188000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2026.4.PEDS2682\/article-10.3171-2026.4.PEDS2682.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":19,"URL":"https:\/\/doi.org\/10.3171\/2026.4.peds2682","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]}}}