Added value of corpus callosotomy following vagus nerve stimulation in children with Lennox-Gastaut syndrome: A multicenter, multinational study

被引：6

作者：

Roth, Jonathan ^{[1
,2
]}

Bergman, Lottem ^{[2
]}

Weil, Alexander G. ^{[3
,4
]}

Brunette-Clement, Tristan ^{[3
,4
]}

Weiner, Howard L. ^{[5
,6
]}

Treiber, Jeffrey M. ^{[5
,6
]}

Shofty, Ben ^{[7
]}

Cukiert, Arthur ^{[8
]}

Cukiert, Cristine Mella ^{[9
]}

Tripathi, Manjari ^{[10
]}

Chandra, Poodipedi Sarat ^{[10
]}

Bollo, Robert J. ^{[11
]}

Machado, Helio Rubens ^{[12
]}

Santos, Marcelo Volpon ^{[13
]}

Gaillard, William D. ^{[14
]}

Oluigbo, Chima O. ^{[15
]}

Ibrahim, George M. ^{[16
]}

Jallo, George I. ^{[17
]}

Shimony, Nir ^{[18
,19
,20
,21
]}

O'Neill, Brent R. ^{[22
]}

Budke, Marcelo ^{[23
]}

Perez-Jimenez, Maria Angeles ^{[24
]}

Mangano, Francesco T. ^{[25
]}

Iwasaki, Masaki ^{[26
]}

Iijima, Keiya ^{[26
]}

Gonzalez-Martinez, Jorge ^{[27
]}

Kawai, Kensuke ^{[28
]}

Ishishita, Yohei ^{[28
]}

Elbabaa, Samer K. ^{[29
]}

Bello-Espinosa, Luis ^{[30
]}

Fallah, Aria ^{[31
]}

Maniquis, Cassia A. B. ^{[31
]}

Ben-Zvi, Ido ^{[32
,33
]}

Tisdall, Martin ^{[32
,33
]}

Panigrahi, Manas ^{[34
]}

Jayalakshmi, Sita ^{[35
]}

Blount, Jeffrey P.

Dorfmuller, Georg ^{[37
]}

Bulteau, Christine ^{[38
]}

Stone, Scellig S. ^{[39
]}

Bolton, Jeffrey ^{[36
,40
]}

Uliel-Sibony, Shimrit ^{[41
]}

机构：

[1] Dana Childrens Hosp, Tel Aviv Med Ctr, Dept Pediat Neurosurg, 6 Weizman St, IL-64239 Tel Aviv, Israel

[2] Tel Aviv Univ, Dana Childrens Hosp, Tel Aviv Med Ctr, Dept Pediat Neurosurg, Tel Aviv, Israel

[3] St Justine Univ Hosp Ctr, Dept Surg, Div Neurosurg, Montreal, PQ, Canada

[4] Univ Montreal Hosp Ctr, Montreal, PQ, Canada

[5] Baylor Coll Med, Texas Childrens Hosp, Dept Neurosurg, Houston, TX USA

[6] Texas Childrens Hosp, Dept Surg, Div Pediat Neurosurg, Houston, TX USA

[7] Univ Utah, Sch Med, Dept Neurosurg, Salt Lake City, UT USA

[8] Clin Cukiert, Dept Neurosurg, Epilepsy Surg Program, Sao Paulo, Brazil

[9] Clin Cukiert, Dept Neurol & Neurophysiol, Epilepsy Surg Program, Sao Paulo, Brazil

[10] AIIMS, Ctr Excellence Epilepsy & MEG, New Delhi, India

[11] Univ Utah, Primary Childrens Hosp, Sch Med, Div Pediat Neurosurg, Salt Lake City, UT USA

[12] Univ Sao Paulo, Ribeirao Preto Med Sch, Ctr Epilepsy Surg Children, Div Pediat Neurosurg, Sao Paulo, Brazil

[13] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Surg & Anat, Div Pediat Neurosurg, Sao Paulo, Brazil

[14] Childrens Natl Med Ctr, Dept Neurol, Washington, DC USA

[15] Childrens Natl Med Ctr, Dept Neurosurg, Washington, DC USA

[16] Univ Toronto, Hosp Sick Children, Dept Surg, Toronto, ON, Canada

[17] Johns Hopkins All Childrens Hosp, Inst Brain Protect Sci, St Petersburg, FL USA

[18] St Jude Childrens Res Hosp, Dept Surg, Memphis, TN USA

[19] Le Bonheur Childrens Hosp, Le Bonheur Neurosci Inst, Memphis, TN USA

[20] Univ Tennessee, Hlth Sci Ctr, Dept Neurosurg, Memphis, TN USA

[21] Johns Hopkins Univ, Sch Med, Dept Neurosurg, Baltimore, MD USA

[22] Childrens Hosp Colorado, Div Pediat Neurosurg, Aurora, CO USA

[23] Nino Jesus Univ Childrens Hosp, Dept Neurosurg, Madrid, Spain

[24] Nino Jesus Univ Childrens Hosp, Dept Neurophysiol, Madrid, Spain

[25] Univ Cincinnati, Cincinnati Childrens Hosp, Coll Med, Div Pediat Neurosurg, Cincinnati, OH USA

[26] Natl Ctr Hosp, Natl Ctr Neurol & Psychiat, Dept Neurosurg, Tokyo, Japan

[27] Univ Pittsburgh, Med Ctr, Dept Neurol Surg, Pittsburgh, PA USA

[28] Jichi Med Univ, Dept Neurosurg, Shimotsuke, Tochigi, Japan

[29] Arnold Palmer Hosp Children, Leon Pediat Neurosci Ctr Excellence, Pediat Neurosurg, Orlando, FL USA

[30] Arnold Palmer Hosp Children, Leon Pediat Neurosci Ctr Excellence, Pediat Neurol & Epilepsy, Orlando, FL USA

[31] UCLA, David Geffen Sch Med, Dept Neurosurg, Los Angeles, CA USA

[32] Great Ormond St Hosp Sick Children, Dept Neurosurg, London, England

[33] UCL, Great Ormond St Inst Child Hlth, Dev Neurosci, London, England

[34] Krishna Inst Med Sci, Dept Neurosurg, Hyderabad, India

[35] Krishna Inst Med Sci, Dept Neurol, Hyderabad, India

[36] Univ Alabama Birmingham, Childrens Hosp Alabama, Dept Neurosurg, Div Pediat Neurosurg, Birmingham, AL USA

[37] Rothschild Fdn Hosp, Pediat Neurosurg Dept, Paris, France

[38] Univ Paris, MC2Lab, Boulogne Billancourt, France

[39] Harvard Med Sch, Boston Childrens Hosp, Dept Neurosurg, Boston, MA USA

[40] Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Boston, MA USA

[41] Tel Aviv Univ, Dana Childrens Hosp, Tel Aviv Med Ctr, Pediat Neurol Unit, Tel Aviv, Israel

来源：

EPILEPSIA | 2023年 / 64卷 / 12期

关键词：

corpus callosotomy; Lennox-Gastaut syndrome; refractory epilepsy; vagus nerve stimulation; DROP ATTACKS; EPILEPSY;

D O I：

10.1111/epi.17796

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective Lennox-Gastaut syndrome (LGS) is a severe form of epileptic encephalopathy, presenting during the first years of life, and is very resistant to treatment. Once medical therapy has failed, palliative surgeries such as vagus nerve stimulation (VNS) or corpus callosotomy (CC) are considered. Although CC is more effective than VNS as the primary neurosurgical treatment for LGS-associated drop attacks, there are limited data regarding the added value of CC following VNS. This study aimed to assess the effectiveness of CC preceded by VNS.Methods This multinational, multicenter retrospective study focuses on LGS children who underwent CC before the age of 18 years, following prior VNS, which failed to achieve satisfactory seizure control. Collected data included epilepsy characteristics, surgical details, epilepsy outcomes, and complications. The primary outcome of this study was a 50% reduction in drop attacks.Results A total of 127 cases were reviewed (80 males). The median age at epilepsy onset was 6 months (interquartile range [IQR] = 3.12-22.75). The median age at VNS surgery was 7 years (IQR = 4-10), and CC was performed at a median age of 11 years (IQR = 8.76-15). The dominant seizure type was drop attacks (tonic or atonic) in 102 patients. Eighty-six patients underwent a single-stage complete CC, and 41 an anterior callosotomy. Ten patients who did not initially have a complete CC underwent a second surgery for completion of CC due to seizure persistence. Overall, there was at least a 50% reduction in drop attacks and other seizures in 83% and 60%, respectively. Permanent morbidity occurred in 1.5%, with no mortality.Significance CC is vital in seizure control in children with LGS in whom VNS has failed. Surgical risks are low. A complete CC has a tendency toward better effectiveness than anterior CC for some seizure types.

引用

页码：3205 / 3212

页数：8

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