Liang Shuli, Li Anmin, Zhao Ming, Jiang Hong, Meng Xiaolun, Sun Yajing
Department of Neurosurgery, Capital Epilepsy Therapy Center, First Affiliated Hospital of General Hospital of Chinese People's Liberation Army, Beijing, China.
Seizure. 2010 Jul;19(6):330-4. doi: 10.1016/j.seizure.2010.05.001. Epub 2010 Jun 15.
To investigate the surgical outcomes of anterior corpus callosotomy (aCCT) combined with anterior temporal lobectomy (ATL) in patients with intractable temporal lobe epilepsy (TLE) and mental retardation (MR).
Sixty patients with TLE and MR were carefully selected and randomly divided into two equal groups: ATL and aCCT, in which they were treated with ATL or ATL combined with aCCT, respectively. Surgical outcomes, including seizure control, IQ and quality of life (QOL) changes, as well as complications were recorded and analyzed 2 years after operation.
Seizure-free status had been achieved in 66.7% of all patients. The aCCT group had higher percentage in Engle Classes I-II than the ATL group (96.7% vs. 80.0%, P<0.05). 56.7% of patients in ATL group and 63.3% in aCCT group had improved full scale IQ (FIQ) after surgery, while the decline of FIQ in aCCT group was less than that of ATL group (3.3% vs. 30.0%). Compared with pre-operative score, the mean post-operative score of performance IQ in aCCT group had improved. Significant difference in QOL change had been found between two groups (P<0.001). 73.7% of patients in aCCT group had their QOL improved with no long-term complications.
ATL combined with aCCT can improve QOL and performance IQ in patients with TLE and MR.
探讨前胼胝体切开术（aCCT）联合前颞叶切除术（ATL）治疗难治性颞叶癫痫（TLE）合并智力障碍（MR）患者的手术效果。
精心挑选60例TLE合并MR患者，随机分为两组，每组30例：ATL组和aCCT组，分别接受ATL或ATL联合aCCT治疗。记录并分析术后2年的手术效果，包括癫痫控制情况、智商和生活质量（QOL）变化以及并发症。
所有患者中有66.7%达到无癫痫发作状态。aCCT组Engle I-II级的比例高于ATL组（96.7%对80.0%，P<0.05）。ATL组56.7%的患者和aCCT组63.3%的患者术后全量表智商（FIQ）有所提高，而aCCT组FIQ的下降幅度小于ATL组（3.3%对30.0%）。与术前评分相比，aCCT组术后操作智商的平均评分有所提高。两组在QOL变化方面存在显著差异（P<0.001）。aCCT组73.7%的患者生活质量得到改善，且无长期并发症。
ATL联合aCCT可改善TLE合并MR患者的生活质量和操作智商。
