You Su Jeong, Kang Hoon-Chul, Ko Tae-Sung, Kim Heung Dong, Yum Mi-Sun, Hwang Yong Soon, Lee Jung-Kyo, Kim Dong Suk, Park Sang Keun
Department of Pediatrics, Epilepsy Center, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
Brain Dev. 2008 Mar;30(3):195-9. doi: 10.1016/j.braindev.2007.07.013. Epub 2007 Sep 6.
To compare the efficacy of corpus callosotomy and vagus nerve stimulation (VNS) for long-term adjunctive therapy in children with Lennox-Gastaut syndrome (LGS).
Fourteen patients underwent a total corpus callosotomy and 10 patients received VNS implantation. The patients were monitored for more than 12 months after treatment, and seizure rates and complications were retrospectively evaluated.
Seizure types among the 24 patients included atonic or tonic seizures with head-drops in 17 patients, generalized tonic seizures in two patients, atypical absence seizures in one patient, generalized tonic-clonic seizures in one patient, and myoclonic seizures in three patients. Of the 14 patients who underwent a corpus callosotomy, nine (64.3%) had a greater than 50% reduction in seizure frequency and five (35.7%) had a greater than 75% reduction. Of the 10 patients who underwent VNS implantation, seven (70.0%) had a greater than 50% reduction in seizure frequency and two (20.0%) had a greater than 75% reduction. There was no significant difference between the two procedures in terms of final efficacy. Complications of corpus callosotomy included aphasia in one patient, ataxia in another, and paresis in a third. Among patients receiving VNS, one patient experienced dyspnea while sleeping and one patient suffered from drooling. These complications were transient and tolerable, and were controlled by simple adjustments of VNS treatment parameters.
The efficacy and safety of corpus callosotomy and VNS were comparable in children with LGS.
比较胼胝体切开术和迷走神经刺激术（VNS）对Lennox-Gastaut综合征（LGS）患儿长期辅助治疗的疗效。
14例患者接受了胼胝体全切开术，10例患者接受了VNS植入术。对患者治疗后进行了超过12个月的监测，并对癫痫发作率和并发症进行了回顾性评估。
24例患者的癫痫发作类型包括：17例患者出现失张力或强直发作伴点头，2例患者出现全身强直发作，1例患者出现不典型失神发作，1例患者出现全身强直阵挛发作，3例患者出现肌阵挛发作。在接受胼胝体切开术的14例患者中，9例（64.3%）癫痫发作频率降低超过50%，5例（35.7%）降低超过75%。在接受VNS植入术的10例患者中，7例（70.0%）癫痫发作频率降低超过50%，2例（20.0%）降低超过75%。两种手术在最终疗效方面无显著差异。胼胝体切开术的并发症包括1例患者出现失语，另1例出现共济失调，第3例出现轻瘫。在接受VNS治疗的患者中，1例患者睡眠时出现呼吸困难，1例患者流口水。这些并发症是短暂且可耐受的，通过简单调整VNS治疗参数即可控制。
胼胝体切开术和VNS对LGS患儿的疗效和安全性相当。
