Anterior corpus callosotomy in school-aged children with Lennox-Gastaut syndrome: a prospective study
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Shuli Liang1, Shaohui Zhang2, Xiaohong Hu3
1Department of Neurosurgery, Capital Epilepsy Therapy Center, First Affiliated Hospital of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Aims:
To compare outcomes of anterior corpus callosotomy (CCT) with anti-epileptic drugs (AEDs) treatment in school-aged children with Lennox-Gastaut syndrome (LGS).
Methods:
Sixty school-aged children with LGS were prospectively enrolled and divided into either the medicine or surgery group according the choice of the patients' caregivers. Cases in the medicine group were treated with multiple rational AEDs and patients in the surgery group underwent anterior CCT. Seizure control at 1-5 years after enrollment and changes of intelligence quotient (IQ) and quality of life (QOL) from pre-treatment to the 2-year follow-up were compared between the two groups.
Results:
The percentages of patients who were totally seizure-free in the surgery group were 17.4% at the 1-year follow-up, 13.0% at the 2-year follow-up and 8.7% at the 5-year follow up, and the data for patients in the medicine group were 2.9%, 5.9% and 2.9%, respectively. Significant differences were found in total seizure control between the two groups at 1, 2, and 5-year follow-up (personal χ2 test). Significant differences were found in mean changes of IQ and overall QOL between the medicine and surgery groups at the 2-year follow-up, showing positive results for the surgery group, but these changes were not related to postoperative outcomes of seizure control (t-test).
Conclusion:
Anterior CCT is a promising treatment for school-aged children with LGS, and can present marked seizure control and improvement in QOL and IQ, all of which were significantly better than the effects of treatment with multiple AEDs.
