Department of Neurology, Taipei Hospital, Department of Health, Executive Yuan, New Taipei City, Taiwan.
J Clin Neurosci. 2012 Mar;19(3):388-93. doi: 10.1016/j.jocn.2011.04.044. Epub 2012 Jan 26.
We aimed to clarify the relationships between post-sectional recruitment of epileptiform discharges (PRED) seen in electrocorticograms (ECoG) during callosotomy in patients with Lennox-Gastaut syndrome (LGS) and postoperative seizure outcome. We retrospectively analyzed ECoG obtained during subtotal callosotomy (6 cm) in 48 patients with LGS (32 males, 16 females; age range, 1-20 years; mean age, 7.6 years) from July 1993 to November 1996 and compared recorded findings with postoperative seizure outcome. At analysis, all patients had been followed postoperatively for more than 10 years. Of 48 patients, 15 (31.3%) had PRED in their post-section ECoG. Of these patients, 11 (73%) achieved significant (at least 50%) overall seizure reduction postoperatively. The phenomenon of PRED in callosotomy did not predict a better postoperative seizure outcome (p>0.05). We concluded that post-sectional ECoG recruitment of electrical discharges during callosotomy did not predict postoperative prognosis. However, this finding should be supported and elucidated by further studies. The heterogenous ECoG findings during callosotomy in our series might suggest a complicated role of the corpus callosum in the epileptogenesis of Lennox-Gastaut syndrome.
我们旨在阐明 Lennox-Gastaut 综合征 (LGS) 患者胼胝体切开术中皮层电图 (ECoG) 中出现的节段后癫痫样放电 (PRED) 与术后癫痫发作结果之间的关系。我们回顾性分析了 1993 年 7 月至 1996 年 11 月期间 48 例 LGS 患者 (32 名男性，16 名女性；年龄 1-20 岁，平均年龄 7.6 岁) 行部分胼胝体切开术 (6cm) 时获得的 ECoG，并将记录的发现与术后癫痫发作结果进行比较。在分析时，所有患者均在术后随访超过 10 年。48 例患者中有 15 例 (31.3%) 在节段后 ECoG 中出现 PRED。这些患者中有 11 例 (73%) 术后总体癫痫发作明显减少 (至少 50%)。胼胝体切开术中 PRED 的现象并不能预测术后更好的癫痫发作结果 (p>0.05)。我们得出结论，胼胝体切开术中电放电的节段后 ECoG 募集并不能预测术后预后。然而，这一发现需要通过进一步的研究来支持和阐明。我们系列中胼胝体切开术中异质的 ECoG 发现可能表明胼胝体在 Lennox-Gastaut 综合征的癫痫发生中起着复杂的作用。
