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

Autor: Roth J; Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel., Bergman L; Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel., Weil AG; Division of Neurosurgery, Department of Surgery, Sainte-Justine University Hospital Centre and University of Montreal Hospital Centre, Montreal, Quebec, Canada., Brunette-Clement T; Division of Neurosurgery, Department of Surgery, Sainte-Justine University Hospital Centre and University of Montreal Hospital Centre, Montreal, Quebec, Canada., Weiner HL; Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.; Division of Pediatric Neurosurgery, Department of Surgery, Texas Children's Hospital, Houston, Texas, USA., Treiber JM; Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.; Division of Pediatric Neurosurgery, Department of Surgery, Texas Children's Hospital, Houston, Texas, USA., Shofty B; Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, Utah, USA., Cukiert A; Department of Neurosurgery, Epilepsy Surgery Program, Clinica Cukiert, Sao Paulo, Brazil., Cukiert CM; Department of Neurology and Neurophysiology, Epilepsy Surgery Program, Clinica Cukiert, Sao Paulo, Brazil., Tripathi M; Center of Excellence for Epilepsy and MEG, AIIMS, New Delhi, India., Sarat Chandra P; Center of Excellence for Epilepsy and MEG, AIIMS, New Delhi, India., Bollo RJ; Division of Pediatric Neurosurgery, University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City, Utah, USA., Machado HR; Division of Pediatric Neurosurgery, Center for Epilepsy Surgery in Children, Ribeirão Preto Medical School, University of São Paulo, Sao Paulo, Brazil., Santos MV; Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Sao Paulo, Brazil., Gaillard WD; Department of Neurology, Children's National Medical Center, Washington, District of Columbia, USA., Oluigbo CO; Department of Neurosurgery, Children's National Medical Center, Washington, District of Columbia, USA., Ibrahim GM; Department of Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada., Jallo GI; Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA., Shimony N; Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.; Le Bonheur Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, Tennessee, USA.; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., O'Neill BR; Division of Pediatric Neurosurgery, Children's Hospital Colorado, Aurora, Colorado, USA., Budke M; Department of Neurosurgery, Niño Jesus University Children's Hospital, Madrid, Spain., Pérez-Jiménez MÁ; Department of Neurophysiology, Niño Jesus University Children's Hospital, Madrid, Spain., Mangano FT; Division of Pediatric Neurosurgery, Cincinnati Children's Hospital, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Iwasaki M; Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan., Iijima K; Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan., Gonzalez-Martinez J; Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., Kawai K; Department of Neurosurgery, Jichi Medical University, Tochigi, Japan., Ishishita Y; Department of Neurosurgery, Jichi Medical University, Tochigi, Japan., Elbabaa SK; Pediatric Neurosurgery, Leon Pediatric Neuroscience Center of Excellence, Arnold Palmer Hospital for Children, Orlando, Florida, USA., Bello-Espinosa L; Pediatric Neurology and Epilepsy, Leon Pediatric Neuroscience Center of Excellence, Arnold Palmer Hospital for Children, Orlando, Florida, USA., Fallah A; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Maniquis CAB; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Ben-Zvi I; Department of Neurosurgery, Great Ormond Street Hospital, London, UK.; Developmental Neurosciences, Great Ormond Street Institute of Child Health, University College London, London, UK., Tisdall M; Department of Neurosurgery, Great Ormond Street Hospital, London, UK.; Developmental Neurosciences, Great Ormond Street Institute of Child Health, University College London, London, UK., Panigrahi M; Department of Neurosurgery, Krishna Institute of Medical Sciences, Hyderabad, India., Jayalakshmi S; Department of Neurology, Krishna Institute of Medical Sciences, Hyderabad, India., Blount JP; Division of Pediatric Neurosurgery, Department of Neurosurgery, University of Alabama at Birmingham, Children's Hospital of Alabama, Birmingham, Alabama, USA., Dorfmüller G; Pediatric Neurosurgery Department, Rothschild Foundation Hospital, Paris, France., Bulteau C; University of Paris, MC2Lab, Boulogne-Billancourt, France., Stone SS; Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Bolton J; Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Singhal A; Division of Pediatric Neurosurgery, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Connolly M; Comprehensive Epilepsy Program, BC Children's Hospital, Vancouver, British Columbia, Canada., Alsowat D; Neuroscience Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Alotaibi F; Neuroscience Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Ragheb J; Department of Surgery, Nicklaus Children's Hospital, University of Miami, Leonard M. Miller School of Medicine, Miami, Florida, USA., Uliel-Sibony S; Pediatric Neurology Unit, Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel.
Jazyk: angličtina
Zdroj: Epilepsia [Epilepsia] 2023 Dec; Vol. 64 (12), pp. 3205-3212. Date of Electronic Publication: 2023 Oct 20.
DOI: 10.1111/epi.17796
Abstrakt: 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.
(© 2023 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)
Databáze: MEDLINE
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