Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Neurosurgery. 2022 May 1;90(5):547-551. doi: 10.1227/neu.0000000000001871.
Recovery time after corpus callosotomy (CC) is known to be longer in elderly than in younger patients.
To evaluate the relationship between patient age and recovery time of activities of daily living (ADL) after 1-stage complete CC.
This study included 41 patients (22 women; aged 13 months-34 years, median 7 years) who underwent 1-stage complete CC for medically intractable seizures with drop attacks, infantile spasms, and/or bilaterally synchronized electroencephalographic discharges between August 2009 and April 2019. The timing of restart of competence in 5 ADL categories and surgical outcomes were recorded.
Patients (1) restarted speech at 2.2 ± 1.3 (mean ± 2 standard deviations; range 1-5) days, (2) restarted replying with their own name on request at 5.5 ± 8.6 (2-33) days, (3) restarted oral intake at 1.6 ± 1.7 (1-11) days, (5) discontinued intravenous feeding at 6.0 ± 3.0 (2-16) days, and (5) restarted ambulation or wheelchair movement at 5.8 ± 3.4 (2-10) days. Younger patients showed significantly (P < .0223) earlier recovery of ambulation or wheelchair movement, but no age difference was found in the other 4 ADL categories. Overall seizure freedom was achieved in 5 patients, excellent (>80%) seizure reduction in 11, good (50%-80%) seizure reduction in 5, and poor (<50%) seizure reduction in 20.
Early ADL recovery after 1-stage complete CC is favorable in both young and adult patients. These findings, with good surgical outcomes, will encourage more positive consideration of 1-stage complete CC in both pediatric and adult patients.
已知胼胝体切开术后（CC）老年患者的恢复期比年轻患者长。
评估 1 期完全 CC 后日常生活活动（ADL）恢复时间与患者年龄的关系。
本研究纳入 2009 年 8 月至 2019 年 4 月期间因药物难治性癫痫伴跌倒发作、婴儿痉挛和/或双侧同步脑电图放电而行 1 期完全 CC 的 41 例患者（22 例女性；年龄 13 个月-34 岁，中位数 7 岁）。记录 5 项 ADL 类别的重新开始能力的时间和手术结果。
患者（1）在 2.2 ± 1.3（平均 ± 2 个标准差；范围 1-5）天开始重新说话，（2）在 5.5 ± 8.6（2-33）天开始重新用自己的名字回答问题，（3）在 1.6 ± 1.7（1-11）天开始重新口服摄入，（5）在 6.0 ± 3.0（2-16）天停止静脉喂养，（5）在 5.8 ± 3.4（2-10）天重新开始步行或轮椅移动。年轻患者的步行或轮椅移动恢复明显（P <.0223）更早，但在其他 4 项 ADL 类别中未发现年龄差异。5 例患者达到完全无癫痫发作，11 例患者癫痫发作明显减少（>80%），5 例患者癫痫发作改善（50%-80%），20 例患者癫痫发作改善不良（<50%）。
1 期完全 CC 后早期 ADL 恢复在年轻和成年患者中均有利。这些发现以及良好的手术结果，将鼓励在儿科和成年患者中更多地考虑 1 期完全 CC。
