更高的智力水平可能是胼胝体切开术后一过性意识障碍的一个风险因素。

Higher intelligence may be a risk factor for postoperative transient disturbance of consciousness after corpus callosotomy.

机构信息

Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka, Japan.

出版信息

Epilepsy Behav. 2021 Feb;115:107617. doi: 10.1016/j.yebeh.2020.107617. Epub 2020 Dec 11.

DOI:10.1016/j.yebeh.2020.107617

PMID:33309425

Abstract

INTRODUCTION

Corpus callosotomy (CC) is an established surgical option for palliative treatment of medically intractable epilepsy, especially for seizures with drop attacks. We postulated that specific risk factors for post-CC transient disturbance of consciousness (pCTDC) are associated with CC. The purpose of this study was to review patients with intractable epilepsy who underwent CC and to statistically analyze risk factors for pCTDC.

METHODS

Inclusion criteria for patients who underwent CC between January 2009 and November 2019 were: (1) ≥2 years old and (2) followed up for more than 8 months. The state of consciousness before and after CC was evaluated with the Glasgow coma scale. We statistically assessed predictors for pCTDC as the primary outcome.

RESULTS

Fifty-six patients (19 females, 37 males) were enrolled, and the age range was 2-57 years old. Thirty-seven (66.1%) patients developed pCTDC. The mean period from the beginning of the state of pCTDC to recovery to their baseline conscious level was 4.9 days (range: 2-25 days). All three (100%) normal intelligence level patients, 13 (81%) of 16 patients with a moderately impaired level of intelligence, and 21 (57%) of 37 patients with a severely impaired level of intelligence exhibited pCTDC. Univariate (p = 0.044) and multivariate (p = 0.006) logistic regression analyses for predictors of pCTDC showed that intellectual function was statistically significant.

CONCLUSION

Two-thirds of patients developed pCTDC. One risk factor for pCTDC may be higher intellectual function.

摘要

简介

胼胝体切开术（CC）是一种成熟的手术选择，用于缓解药物难治性癫痫，尤其是伴有猝倒发作的癫痫。我们假设 CC 后短暂意识障碍（pCTDC）的特定危险因素与 CC 有关。本研究的目的是回顾接受 CC 的耐药性癫痫患者，并对 pCTDC 的危险因素进行统计学分析。

方法

纳入标准为 2009 年 1 月至 2019 年 11 月期间接受 CC 的患者：（1）年龄≥2 岁；（2）随访时间超过 8 个月。采用格拉斯哥昏迷量表评估 CC 前后的意识状态。我们对 pCTDC 的预测因素进行了统计学评估，作为主要结果。

结果

共纳入 56 例患者（女性 19 例，男性 37 例），年龄范围为 2-57 岁。37 例（66.1%）患者出现 pCTDC。从 pCTDC 开始到恢复到基线意识水平的平均时间为 4.9 天（范围：2-25 天）。所有 3 例（100%）智力正常水平的患者、16 例智力中度受损患者中的 13 例（81%）和 37 例智力严重受损患者中的 21 例（57%）均出现 pCTDC。单因素（p=0.044）和多因素（p=0.006）逻辑回归分析显示，智力功能是预测 pCTDC 的统计学显著因素。