胼胝体切开术后非癫痫症状随访结果分析

Follow-up analysis of nonseizure-related outcomes after corpus callosotomy

目的探讨胼胝体切开术后难治性癫痫的有效性、安全性及非癫痫症状改善情况。方法 9例难治性癫痫患者均行胼胝体前2/3切开手术,其中2例联合致痫灶切除。结果随访平均38.7个月(2例失访),采用修正Engel分级评估患者术后癫痫控制情况:EngelⅠ级2例,EngelⅡ级2例,EngelⅢ级1例,EngelⅣ级2例,并根据1998年国际癫痫会议上讨论的"癫痫术后生活质量预后分类",结合本组患者的实际情况,发现2例患者术后认知表现有明确改善,达到I级,其余4例均为Ⅱ级。社会功能方面,2例达Ⅰ级,3例为Ⅱ级,1例无变化。结论胼胝体切开术后患者认知、职业等非癫痫症状及生活质量改善明显,且可能与癫痫控制率并不完全相关。

Objective To investigate the efficacy, safety and nonselzure-relatecl outcomes ot retractory epnepsy after corpus callosotomy. Methods Nine patients with refractory epilepsy underwent anterior2/3 corpus callosotomy, 2 of which were combined with removal of epileptic loci. Results After the average follow-up of 38. 7 months（2 cases were lost）, the results were classified by modified Engel grade. 2 cases were Engel Ⅰ, 2 cases were Engel Ⅱ , 1 case was Engel Ⅲ, 2 cases were Engel Ⅳ. According to ＂post-epilepsy postoperative quality of life prognosis classification＂ discussed by the International Society of Epilepsy, combined with the actual situation of patients in this group,we found that 2 patients with postoperative cognitive performance improved significantly to Class Ⅰ, the remaining 4 cases were Level Ⅱ. In terms of social function, 2 cases achieved grade Ⅰ, 3 cases were grade Ⅱ ,and 1 case had no changes. Conclusion The quality of life of patients with cognition and occupation after corpus callosum incision is obviously improved, which may not be completely associated with the outcomes of seizure control.