Surgical outcome of corpus callosotomy in patients with drop attacks
Surgical outcome of corpus callosotomy in patients with drop attacks
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DOI：
10.1046/j.1528-1157.2001.081422.x
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发表时间：
2001-01-01
期刊：
影响因子：
5.6
通讯作者：
Shimizu, H
中科院分区：
文献类型：
--
作者：
Maehara, T;Shimizu, H
目的：我们研究了独立影响胼胝体切开术后手术结果的术前因素。为了充分衡量手术结果，我们分析了跌倒发作的癫痫结果、术后总体日常功能和家庭满意度。方法：胼胝体切开术后至少 2 年（平均 40.0 个月），我们回顾性调查了 52 名跌倒发作的患者。作为术前因素，我们分析了手术年龄、癫痫发作年龄、跌倒发作年龄、性别、偏瘫、严重智力低下、EEG异常、MRI异常和胼胝体部分切除范围（全胼胝体切开术或部分胼胝体切开术）。采用逐步logistic回归进行分析。结果：85%的癫痫发作患者、32%的全身强直发作患者和31%的全身强直阵挛发作患者获得了满意的结果（癫痫发作停止或癫痫发作减少>90%）。家属评估称，62% 的患者总体日常功能得到改善，23% 的患者没有变化，15% 的患者出现受损。 83% 的患者对胼胝体切开术的家人表示满意（绝对满意，39%，有些满意，44%）。全胼胝体切开术可独立预测跌倒发作的令人满意的减少（p = 0.013）。年龄较小可以独立预测整体日常功能的改善（受损和改善：p = 0.004）和家庭满意度（不满意和有些满意，p = 0.018；不满意和绝对满意，p = 0.0006）。 结论：在本研究中，我们发现全胼胝体切开术比部分胼胝体切开术治疗跌倒发作更有效，并且儿童在胼胝体切开术后比成人获得更多益处。
Purpose: We examined presurgical factors that independently influence surgical outcome after corpus callosotomy. For adequate measurement of the surgical outcome, we analyzed seizure outcome of drop attacks, postoperative overall daily function, and family satisfaction.Methods: At least 2 years after callosotomy (mean, 40.0 months), we retrospectively investigated 52 patients with drop attacks. As presurgical factors, we analyzed the age at surgery, age at seizure onset, age at drop attack onset, sex, hemiparesis, severe mental retardation, EEG abnormality, MRI abnormality, and extent of callosal section (total or partial callosotomy). Stepwise logistic regression was used for analysis.Results: Satisfactory outcome (seizure cessation or >90% seizure reduction) was achieved in 85% of patients with drop attacks, 32% of those with generalized tonic seizures, and 31% of those with generalized tonic-clonic seizures. The families assessed the overall daily function as improved in 62% of patients, unchanged in 23%, and impaired in 15%. Family satisfaction with callosotomy was achieved in 83% of patients (definitely satisfied, 39%, somewhat satisfied, 44%). Total callosotomy is independently predictive of satisfactory reduction of drop attacks (p = 0.013). A younger age is independently predictive of improvement of overall daily function (impaired and improved: p = 0.004) and family satisfaction (unsatisfied and somewhat satisfied, p = 0.018; unsatisfied and definitely satisfied, p = 0.0006).Conclusions: In the present study, we found that total callosotomy is more effective for treatment of drop attacks than partial callosotomy and that children receive more benefit than adults after callosotomy.