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胼胝体切开术是 Lennox-Gastaut 综合征和药物难治性癫痫患者的一种有价值的治疗选择。

Corpus callosotomy is a valuable therapeutic option for patients with Lennox-Gastaut syndrome and medically refractory seizures.

机构信息

Department of Neurology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, USA.

出版信息

Epilepsy Behav. 2013 Nov;29(2):285-8. doi: 10.1016/j.yebeh.2013.08.011. Epub 2013 Sep 5.

Abstract

PURPOSE

We present our experience with corpus callosotomy (CC) in a developing country with limited resources in patients with Lennox-Gastaut syndrome (LGS) and medically refractory seizures.

METHODS

All patients with LGS who underwent CC for medically refractory epilepsy at Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran from May 2009 through March 2012 were reviewed in a retrospective study. Presurgical evaluation included clinical history, neurological examination, a 2-hour video-EEG recording, and 1.5-T MRI. Outcome was evaluated at 6, 12, and 24 months postoperatively. We considered the outcome as a success if the patients were either seizure-free or had more than 85% reduction in seizure frequency compared to their preoperative status.

RESULTS

Eighteen patients (14 males and 4 females) had surgery. Overall, seizures in 11 patients (61.1%) responded favorably one year after surgery; this figure was 6 out of 9 patients (66.6%) two years after surgery. Seven patients (38.8%) were free of disabling seizures one year after CC; this figure was three out of nine patients (33.3%) two years after CC. Three patients (16.6%) were free of all seizure types one year after surgery. Ten patients (55.5%) had no postoperative complications of any kind.

CONCLUSION

Corpus callosotomy is an effective palliative surgical procedure for patients with LGS with intractable seizures whose seizures are not amenable to focal resection. This is a feasible treatment option for patients, even for those in developing countries with limited resources.

摘要

目的

我们介绍了在资源有限的发展中国家,对 Lennox-Gastaut 综合征(LGS)和药物难治性癫痫患者进行胼胝体切开术(CC)的经验。

方法

对 2009 年 5 月至 2012 年 3 月期间在伊朗 Shiraz 大学 Namazee 医院接受 CC 治疗药物难治性癫痫的所有 LGS 患者进行回顾性研究。术前评估包括临床病史、神经系统检查、2 小时视频脑电图记录和 1.5-T MRI。术后 6、12 和 24 个月进行结果评估。如果患者术后无发作或与术前相比发作频率减少 85%以上,则认为结果为成功。

结果

18 例患者(男 14 例,女 4 例)接受了手术。总体而言,11 例患者(61.1%)术后 1 年癫痫发作得到良好控制;2 年后这一数字为 9 例中的 6 例(66.6%)。7 例患者(38.8%)术后 1 年无致残性癫痫发作;这一数字为 9 例中的 3 例(33.3%)。术后 1 年,3 例患者(16.6%)所有类型的癫痫发作均消失。10 例患者(55.5%)无任何类型的术后并发症。

结论

对于药物难治性癫痫且癫痫发作不适于局灶性切除的 LGS 患者,胼胝体切开术是一种有效的姑息性手术。对于患者来说,即使是在资源有限的发展中国家,这也是一种可行的治疗选择。

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