Objective To explore the efficacy and safety of total corpus callosotomy for children with epilepsy.Methods A total of 24 children with epilepsy were selected from the Epilepsy Center at Shanghai Neuromedical Center from June 2017 to August 2022.All of them underwent total corpus callosotomy.Clinical baseline data of the children was collected and the prognosis was assessed.Re-sults The children included in this study were aged 2～13 years,with an average age of 6.2 years.A-mong them,there were 7 children with generalized epileptic seizures and 17 children with atonic sei-zure and falling attack.Postoperative follow-up was conducted for 5 years,with an average follow-up time of 2.8 years.There were 16 children whose frequency of postoperative seizures was decreased by≥50％,5 cases whose frequency was decreased by＜50％or worsened.The remaining 3 cases had missing postoperative follow-up data.The postoperative seizure results were graded based on Engel score,including 7 children of Engel grade Ⅰ,3 children of Engel grade Ⅱ,6 children of Engel grade Ⅲand 5 children of Engel grade Ⅳ.After surgery,13 children showed significant improvement in intel-ligence,growth and development,and most of them were the children with a reduction of 50％in postoperative seizure frequency.Among them,the improvements in language and physical activity were very common.Among 24 cases,there was 1 child with severe complications,who had postopera-tive cerebral infarction and underwent decompressive craniectomy,and 1 child who had subdural fluid accumulation and underwent drilling drainage.All child had no occurrence of intracranial infection,hydrocephalus and cerebral hemorrhage after surgery.Conclusion Total corpus callosotomy has a good effect on children with generalized seizures,atonic seizures and fall attacks.Its efficiency is higher than that of partial corpus callosotomy alone.The incidence of complications is not significantly in-creased.Postoperatively,it can greatly promote the growth and development of children and improve their intelligence.The earlier the surgery for children with epilepsy,the lower the incidence of compli-cations,and the better the surgical effect than that of older children.
关键词
药物难治性癫痫/跌倒发作/失张力发作/全面性发作/胼胝体全段切开术
Key words
drug resistant epilepsy/falling attack/atonic seizures/generalized seizures/total corpus callosotomy
维普
万方数据