Long-term seizure outcome after corpus callosotomy: a retrospective analysis of 95 patients
Long-term seizure outcome after corpus callosotomy: a retrospective analysis of 95 patients
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DOI：
10.3171/2008.3.17570
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发表时间：
2009-02-01
影响因子：
4.1
通讯作者：
Dubeau, Francois
中科院分区：
文献类型：
--
作者：
Tanriverdi, Taner;Olivier, Andre;Dubeau, Francois
物体。作者报告了蒙特利尔神经病学研究所1981-2001年间接受胼胝体切开术的患者癫痫发作的长期随访结果。对95例至少随访5年(平均17.2年)的患者的发作情况、用药结果和影响发作结果的预后因素进行了回顾分析。所有患者都有不止一种类型的癫痫发作，最常见的是跌倒发作和全身性强直阵挛发作。致残率最高的发作类型是跌倒发作，其次是全身性强直阵挛发作。在几种发作类型中都有改善，最有可能的是全身性强直阵挛发作(77.3%)和跌落发作(77.2%)。简单的部分主音，泛音主音。而肌阵挛发作也得益于膝盖骨前切开术。颧骨切开的范围与良好的癫痫结果相关。并发症轻微，一过性，无死亡。这项研究证实，对于难治性全身性癫痫发作不能局部切除的情况，膝盖骨前切开术是一种有效的治疗方法。在考虑这一过程时，治疗医生必须彻底评估预期的益处、局限性、残留癫痫发作的可能性和风险，并向患者、他或她的家人和其他护理人员解释这些情况。(DOI：10.3171/2008.3.17570)
Object. The authors report long-term follow-Up seizure outcome in patients who underwent corpus callosotomy during the period 1981-2001 at the Montreal Neurological Institute.Methods. The records of 95 patients with a minimum follow-Lip of 5 years (mean 17.2 years) were retrospectively evaluated with respect to seizure, medication outcomes, and prognostic factors on seizure outcome.Results. All patients had more than one type of seizure, most frequently drop attacks and generalized tonic-clonic seizures. The most disabling seizure type was drop attacks, followed by generalized tonic-clonic seizures. Improvement was noted in several seizure types and was most likely for generalized tonic-clonic seizures (77.3%) and drop attacks (77.2%). Simple partial, generalized tonic. and myoclonic seizures also benefited from anterior callosotomy. The extent of the callosal section was correlated with favorable seizure outcome. The complications were mild and transient and no death was seen.Conclusions. This study confirms that anterior callosotomy is an effective treatment in intractable generalized seizures that are not amenable to focal resection. When considering this procedure, the treating physician must thoroughly assess the expected benefits, limitations, likelihood of residual seizures, and the risks, and explain them to the patient, his or her family, and other caregivers. (DOI: 10.3171/2008.3.17570)