胼胝体切开术治疗儿童药物难治性癫

Corpus callosotomy in the treatment of children with medically intractable epilepsy

目的探讨胼胝体切开术治疗无法行局灶性切除的儿童药物难治性癫的安全性及有效性。方法回顾性分析113例儿童药物难治性癫病人的临床资料,均行胼胝体切开术。结果术后发作完全消失77例（68.1%）,发作减少90%以上21例（18.6%）,其中失张力性发作病人术后发作完全消失和发作减少90%以上者分别占94.1%和5.9%,而全身强直性发作病人为8.3%和75.0%。术后出现短暂的主动性语言减少3例,并在术后6-8 d内恢复。随访113例,时间12个月~5年,病人精神发育状态均有不同程度的改善,无发作加重病例。结论胼胝体切开术是治疗儿童药物难治性癫的一种安全有效的方法,特别是对失张力性发作和全身强直性发作效果更佳。

Objective To evaluate the safety and efficiency of corpus callosotomy in the treatment of children with medically intractable epilepsy which could not be resected focally.Methods Clinical data of 113 children with medically intractable epilepsy were analyzed retrospectively who underwent corpus callosotomy.Results The seizure disappeared completely in 77 patients（68.1%） and decreased by more than 90% in 21（18.6%） after operation.The patients whose seizures disappeared completely and decreased by more than 90% after operation accounted for 94.1% and 5.9% respectively in patients with atonic seizure,while for 8.3% and 75.0% respectively in patients with generalized tonic seizure.Transient active speech reduction occurred in 3 patients who recovered 6 to 8 days after operation.One hundred and thirteen patients were followed up for 12 months to 5 years,mental development state of all the patients was improved to different degrees and no exacerbation of seizure occurred.Conclusions Corpus callosotomy is a safe and effective treatment for children with medically intractable epilepsy,especially for patients with atonic or generalized tonic seizures.