Calosotomia nas epilepsias generalizadas refratarias

AUTOR(ES)
DATA DE PUBLICAÇÃO

1996

RESUMO

We studied 51 patients with refractory generalized epilepsies, submitted to partial or complete callosotomy. The ages varied from 1 yr to 28 years, mean of 9,4 years. Twenty eight patients were male and 23 female. Ali patients were treated for a minimum of 6 months before surgical indication. Ali were proved refractory to medical treatment, and had no signs of a focal resectable cortical lesion. Types of seizures studied were atonic, tonic, tonic-clonic, absences, myoclonic, partia I and serial spasms. Ali patients presented more than one seizure type, 86% of them presenting with three or more types of seizures. There was a significant decrease in the number of ali types of seizures, after surgery. There was a significant difference between the two procedures, with better results for the group submitted to complete section, for the following seizure types: absences, myoclonic and serial spasms. This was als9 true of tonic-clonic seizures, for the patients with West syndrome. Twenty six of the 51 patients had a more than 75% control for two of three, three of four or four of five of their seizure types. Atonic (79,6%), followed by absence (64%) seizures, were the seizure types which showed the highest improvement. Our results, together with data from the review of the literature, suggest that callosotomy is an effective procedure to decrease the frequency of some types of seizures, specially atonic, absences and tonic. Complete callosotomy seems to be more effective to decrease myoclonic, absences and spasms, specially in patients with severe encephalopathies. The data point to mfxed commissural and subcortical mechanisms, active in the refractory symptomatic generalized epilepsies, helping to explain the limitations of callosotomy in allaying the seizures of these patients

ASSUNTO(S)

tratamento cirurgico convulsões epilepsia

ACESSO AO ARTIGO

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