Liang Shuli, Zhang Shaohui, Hu Xiaohong, Zhang Zhiwen, Fu Xiangping, Jiang Hong, Xiaoman Yu
Department of Neurosurgery, Capital Epilepsy Therapy Center, First Affiliated Hospital of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Capital Epilepsy Therapy Center, First Affiliated Hospital of PLA General Hospital, Beijing, China.
Eur J Paediatr Neurol. 2014 Nov;18(6):670-6. doi: 10.1016/j.ejpn.2014.05.004. Epub 2014 May 22.
To compare outcomes of anterior corpus callosotomy (CCT) with anti-epileptic drugs (AEDs) treatment in school-aged children with Lennox-Gastaut syndrome (LGS).
Sixty school-aged children with LGS were prospectively enrolled and divided into either the medicine or surgery group according the choice of the patients' caregivers. Cases in the medicine group were treated with multiple rational AEDs and patients in the surgery group underwent anterior CCT. Seizure control at 1-5 years after enrollment and changes of intelligence quotient (IQ) and quality of life (QOL) from pre-treatment to the 2-year follow-up were compared between the two groups.
The percentages of patients who were totally seizure-free in the surgery group were 17.4% at the 1-year follow-up, 13.0% at the 2-year follow-up and 8.7% at the 5-year follow up, and the data for patients in the medicine group were 2.9%, 5.9% and 2.9%, respectively. Significant differences were found in total seizure control between the two groups at 1, 2, and 5-year follow-up (personal χ2 test). Significant differences were found in mean changes of IQ and overall QOL between the medicine and surgery groups at the 2-year follow-up, showing positive results for the surgery group, but these changes were not related to postoperative outcomes of seizure control (t-test).
Anterior CCT is a promising treatment for school-aged children with LGS, and can present marked seizure control and improvement in QOL and IQ, all of which were significantly better than the effects of treatment with multiple AEDs.
比较胼胝体前切开术（CCT）与抗癫痫药物（AEDs）治疗 Lennox-Gastaut 综合征（LGS）学龄儿童的疗效。
前瞻性纳入 60 例 LGS 学龄儿童，根据患者监护人的选择分为药物治疗组或手术治疗组。药物治疗组采用多种合理的抗癫痫药物治疗，手术治疗组患者接受胼胝体前切开术。比较两组入组后 1 - 5 年的癫痫控制情况以及从治疗前到 2 年随访时智商（IQ）和生活质量（QOL）的变化。
手术治疗组 1 年随访时完全无癫痫发作的患者比例为 17.4%，2 年随访时为 13.0%，5 年随访时为 8.7%；药物治疗组患者的数据分别为 2.9%、5.9%和 2.9%。在 1 年、2 年和 5 年随访时，两组在癫痫总体控制方面存在显著差异（自身χ²检验）。在 2 年随访时，药物治疗组和手术治疗组在 IQ 和总体 QOL 的平均变化方面存在显著差异，手术治疗组显示出阳性结果，但这些变化与术后癫痫控制结果无关（t 检验）。
胼胝体前切开术是治疗 LGS 学龄儿童的一种有前景的治疗方法，可显著控制癫痫发作，并改善生活质量和智商，所有这些均明显优于多种抗癫痫药物治疗的效果。
