Abstract:
Corpus callosotomy (CC) is a palliative treatment for drop seizures in patients with drug-resistant nonlocalizable epilepsy. We compared drop seizure outcomes between patients undergoing anterior CC versus complete CC and examined factors impacting outcomes for drop seizures including age at CC and duration of epilepsy. A retrospective review of patients who underwent CC between 2003 and 2022 with a minimum of 6 months postsurgical follow-up was included. Outcome measure for drop seizures included seizure reduction ≥50% from baseline as well as elimination of drop seizures. Thirty-eight patients were included. Overall, ≥50% reduction in drop seizures occurred in nearly 70% (23 out of 33) patients with complete elimination in 58% (19 out of 33). Compared with anterior CC (n = 13), patients undergoing complete CC (n = 25) had increased likelihood of ≥50% reduction (p = 0.006) or elimination (p = 0.024) of drop seizures. Regression analysis showed that complete CC was the primary predictor for improved drop seizure outcomes (elimination, p = 0.014 or ≥50% reduction, p = 0.006), while age at CC and duration of epilepsy did not impact the outcomes. Compared to anterior CC, complete CC was significantly more likely to lead to improvement/freedom from drop seizures. Age at CC or duration of epilepsy did not influence drop seizure outcomes.
摘要:
Corpuscall切开术(CC)是一种姑息性治疗,用于治疗耐药性不可定位的癫痫患者的癫痫发作。我们比较了接受前CC与完全CC的患者之间的跌落性癫痫发作结果,并检查了影响跌落性癫痫发作结果的因素,包括CC年龄和癫痫持续时间。包括对2003-2022年间接受CC的患者进行回顾性审查,并在手术后至少随访6个月。滴落发作的结果测量包括从基线减少≥50%的发作以及消除滴落发作。包括38名患者。总的来说,近70%(33例中的23例)的患者减少了≥50%的癫痫发作,而58%(33例中的19例)的患者完全消除了癫痫发作。与前CC(n=13)相比,接受完全CC的患者(n=25)出现跌落性癫痫发作减少≥50%(p=0.006)或消除(p=0.024)的可能性增加.回归分析显示,完全CC是改善跌落性癫痫发作结果的主要预测因子(消除,p=0.014或≥50%的减少,p=0.006),而CC年龄和癫痫持续时间对结局无影响.与前CC相比,完全CC明显更有可能导致改善/免于跌落癫痫发作。CC年龄或癫痫持续时间不影响癫痫发作的结果。