Luat Aimee F, Asano Eishi, Kumar Ajay, Chugani Harry T, Sood Sandeep
1 Department of Pediatrics, Detroit Medical Center, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA.
2 Department of Neurology, Detroit Medical Center, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA.
J Child Neurol. 2017 Jun;32(7):624-629. doi: 10.1177/0883073817697847. Epub 2017 Mar 8.
Corpus callosotomy is a palliative procedure performed to reduce the severity of drug-resistant epilepsy. The authors assessed its efficacy on different seizure types in 20 subjects (age range 5-19 years); 8 with active vagus nerve stimulator. Fifteen had complete callosotomy, 3 had anterior 2/3, and 2 had anterior 2/3 followed later by complete callosotomy. Ten had endoscopic approach. In all, 65% had ≥ 50% reduction of generalized seizures leading to falls (atonic, tonic, myoclonic); 35% became seizure-free (follow-up period: 6 months to 9 years; mean 3 years). Seizure outcome distribution was better for generalized than for partial seizures ( P = .003). Endoscopic approach was as effective as transcranial approach. Seven subjects who failed vagus nerve stimulator therapy responded with ≥50% seizure reduction. Corpus callosotomy is an effective treatment for intractable generalized epilepsy leading to falls with significant seizure reduction or even elimination of seizures, in the majority of children.
胼胝体切开术是一种用于减轻耐药性癫痫严重程度的姑息性手术。作者评估了该手术对20名受试者（年龄范围5 - 19岁）不同发作类型的疗效；其中8名受试者同时使用了活性迷走神经刺激器。15名受试者接受了完全胼胝体切开术，3名接受了前2/3胼胝体切开术，2名先接受了前2/3胼胝体切开术，随后又接受了完全胼胝体切开术。10名受试者采用了内镜手术方法。总体而言，65%的受试者导致跌倒的全身性发作（失张力性、强直性、肌阵挛性）减少了≥50%；35%的受试者实现了无发作（随访期：6个月至9年；平均3年）。全身性发作的发作结果分布优于部分性发作（P = 0.003）。内镜手术方法与经颅手术方法效果相同。7名迷走神经刺激器治疗失败的受试者发作减少了≥50%。胼胝体切开术是治疗导致跌倒的顽固性全身性癫痫的有效方法，在大多数儿童中可显著减少发作甚至消除发作。
