Abstract：
PURPOSE:Corpus callosotomy and vagus nerve stimulation are common palliative options for people with drug-resistant epilepsy when resective epilepsy surgery is not feasible. Because most of the published corpus callosotomy experience comes from a period before vagus nerve stimulation was approved and widely used, there is a paucity of data about efficacy of corpus callosotomy in patients with inadequate response to vagus nerve stimulation. METHODS:We report seven patients who had complete corpus callosotomy after an inadequate response to vagus nerve stimulation. At the time of surgery, these patients had failed a median of six antiseizure medications, three patients also had failed a trial of ketogenic diet, and all the patients had a vagus nerve stimulation implanted for a mean duration of 2.5 years with maximal tolerated settings. RESULTS:There was a decrease in total daily seizure frequency of 34.7% (± 94.7; median, 71.4%; interquartile range, 55.3) after corpus callosotomy at a mean follow-up of 2.6 years (± 1.4). One patient achieved complete seizure freedom and five patients had ≥ 50% reduction in seizure frequency. Six patients continued to have partial-onset seizures though the frequency was decreased. Drop attacks and tonic seizures stopped in all the patients. CONCLUSION:Seizure outcomes after corpus callosotomy in our series are most likely a result of complex dynamic interaction between the natural history of epilepsy, the effect of the surgery, ongoing vagus nerve stimulation modulation, and modification in antiseizure drugs. Our study supports the clinical decision to try corpus callosotomy in patients having nonlateralizing drug-resistant epilepsy with inadequate response to vagus nerve stimulation.
journal_name
Pediatr Neuroljournal_title
Pediatric neurologyauthors
Arya R,Greiner HM,Horn PS,Turner M,Holland KD,Mangano FTdoi
10.1016/j.pediatrneurol.2014.09.008subject
Has Abstractpub_date
2014-12-01 00:00:00pages
800-5issue
6eissn
0887-8994issn
1873-5150pii
S0887-8994(14)00577-3journal_volume
51pub_type
杂志文章abstract：:The aim of the study was to assess neurologic complications of pertussis infection. A file review of all children (age 7-18 years) in our hospital with serology-positive pertussis infection admitted from 1995 to 2005 yielded six patients with neurologic symptoms in whom electroencephalographic studies were performed. ...
journal_title：Pediatric neurology
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pub_type： 杂志文章,随机对照试验
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更新日期：1997-11-01 00:00:00
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更新日期：2007-12-01 00:00:00
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journal_title：Pediatric neurology
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