Changing the paradigm of 1-stage total callosotomy for the treatment of pediatric generalized epilepsy.
Changing the paradigm of 1-stage total callosotomy for the treatment of pediatric generalized epilepsy.
复制标题
改变一期全胼胝体切开术治疗小儿全身性癫痫的范例。
DOI：
--
复制
发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Dong
中科院分区：
文献类型：
--
作者：
K. Shim;Young;H. Kim;Jun;Joong;Dong
对象
作者提出，前胼胝体切开术-被认为比全胼胝体切开术有一些优势-在预防癫痫蔓延或其他并发症方面并不上级全胼胝体切开术。
方法
该研究包括34例被诊断为全身性癫痫综合征或继发全身性额叶癫痫发作的患者。术前，所有患者均患有致残性跌倒发作或剧烈头下垂癫痫发作，部分患者还发生了其他类型的癫痫发作。男性/女性比例为22：12，患者年龄范围为1 - 19岁（平均8.7岁）。随访时间1.08 ~ 5.0年，平均2.58年。术后评估癫痫发作结局、父母对日常功能的评估以及父母对结局的满意度。
结果
在接受一期全胼胝体切开术后，随访期间25例患者的跌倒发作完全消失，6例患者的跌倒发作频率降至基线的10%以下。至于其他类型的癫痫发作，12例患者的癫痫发作完全消退，另外18例患者的癫痫发作频率降低。2例患者出现短暂性断线综合征2周和4周。1例患者在完全缓解前出现共济失调性轻偏瘫3周。患者的整体日常功能得到改善，所有家长对手术结果都很满意。
结论
对于儿童全面性癫痫综合征，一期胼胝体全切开术将是控制全面性癫痫发作的首选治疗方法。
OBJECT
The authors propose that anterior callosotomy -- thought to have some advantages over total callosotomy -- is not superior to total callosotomy for prevention of seizure propagation or other complications.
METHODS
The study comprised 34 patients in whom generalized epilepsy syndrome or frontal lobe seizures with a secondary generalization were diagnosed. Preoperatively, all patients suffered from disabling drop attacks or intense head-drop seizures, and some patients also experienced other types of seizures. The male/female ratio was 22:12, and patients ranged in age between 1 to 19 years (mean 8.7 years). The follow-up period ranged from 1.08 to 5.0 years (mean 2.58 years). Seizure outcome, parental assessment of daily function, and parental satisfaction with the outcome was assessed postoperatively.
RESULTS
After undergoing 1-stage total callosotomy, drop attacks disappeared completely in 25 patients during the follow-up period, and in 6 patients the frequency of drop attacks decreased to < 10% of baseline. With regard to other types of seizures, seizures resolved completely in 12 patients, and in another 18 seizure frequency decreased. Two patients experienced a transient disconnection syndrome for 2 and 4 weeks. One patient experienced ataxic hemiparesis for 3 weeks before it completely abated. The overall daily function of the patients improved, and all parents were satisfied with the surgical outcome.
CONCLUSIONS
For pediatric generalized epilepsy syndrome, 1-stage total callosotomy will be the first choice in treatment for controlling generalized seizures.