Duc Lien Nguyen, Tuan Dang Anh, Vu Hung Cao, Lepard Jacob R, Rocque Brandon G
1Neurosurgical Department, Vietnam National Cancer Hospital, Hanoi.
2Neurology Department, National Hospital of Pediatrics, Hanoi, Vietnam.
J Neurosurg Pediatr. 2020 Feb 28;25(6):582-587. doi: 10.3171/2019.12.PEDS19638. Print 2020 Jun 1.
The aim of this study was to evaluate postoperative seizure outcome in children with drug-resistant epilepsy not eligible for focal resection who underwent corpus callosotomy.
The study included 16 patients undergoing corpus callosotomy between September 2015 and May 2018. Seizure semiology and frequency, psychomotor status, and video electroencephalography and imaging findings were evaluated for all patients.
Of the 16 patients who underwent callosotomy during the study period, 11 underwent complete callosotomy and 5 underwent anterior only. Seizure improvement greater than 75% was achieved in 37.5% of patients, and another 50% of patients had seizure improvement of 50%-75%. No sustained neurological deficits were observed in these patients. There were no significant complications. Duration of postoperative follow-up ranged from 12 to 44 months.
Corpus callosotomy is an effective treatment for selected patients with drug-resistant epilepsy not eligible for focal resection in resource-limited settings. Fostering and developing international epilepsy surgery centers should remain a high priority for the neurosurgical community at large.
本研究旨在评估在资源有限的环境中,接受胼胝体切开术的药物难治性癫痫患儿术后的癫痫发作结果,这些患儿不符合局灶性切除术的条件。
该研究纳入了2015年9月至2018年5月期间接受胼胝体切开术的16例患者。对所有患者的癫痫发作症状学和频率、精神运动状态、视频脑电图及影像学检查结果进行了评估。
在研究期间接受胼胝体切开术的16例患者中,11例行完全胼胝体切开术,5例行仅前部胼胝体切开术。37.5%的患者癫痫发作改善率大于75%,另有50%的患者癫痫发作改善率为50%-75%。这些患者未观察到持续性神经功能缺损。无明显并发症。术后随访时间为12至44个月。
在资源有限的环境中,胼胝体切开术是治疗不符合局灶性切除术条件的特定药物难治性癫痫患者的有效方法。对广大神经外科界而言,建立和发展国际癫痫手术中心仍应是高度优先事项。