Seizure Outcome after Anterior versus Complete Corpus Callosotomy in Children: A Systematic Review with Meta-Analysis

Abstract

Introduction Refractory epilepsy is a debilitating and challenging condition to manage. Corpus callosotomy (CC) seems to be an effective treatment option for patients with seizures not amenable to focal resection. The aim of the present study is to compare seizure outcome of pediatric patients following anterior CC, compared with complete CC.

Method The authors performed a systematic review and meta-analysis of the English literature involving comparative studies.

Results The present investigation includes four retrospective case-controlled studies and authors perform a pooled analysis of the surgical results. Seizure outcome presented favorable results in patients who underwent complete CC (Odds Ratio, M-H, Fixed, 95% CI: 3.02 [1.43, 6.387], p-value: 0.005). Clinical and neurological complications occurred independently when a complete or anterior CC was performed.

Conclusion Complete CC seems to be the most effective treatment option to control intractable seizure in children not amenable to focal resection.

Resumo

Introdução Epilepsia refratária é uma condição debilitante e desafiadora para lidar. Calosotomia parece ser uma opção de tratamento eficaz para pacientes com convulsões não passíveis de ressecção focal. O objetivo do presente estudo é comparar o resultado de convulsões em pacientes pediátricos de acordo com calosotomia anterior e completa.

Métodos Uma revisão sistemática e metanálise da literatura médica em inglês envolvendo estudos comparativos.

Resultados Quatro casos retrospectivos foram incluídos na presente investigação e uma análise dos resultados cirúrgicos foi realizada. Convulsões decorrentes tiveram resultados favoráveis em pacientes submetidos a calosotomia complete (odds ratio, M-H, fixo, 95% IC: 3,02 [1,43; 6,387], valor de p: 0,005). Complicações clínicas e neurológicas ocorreram independentemente de se calosotomia complete ou anterior.

Conclusão Calosotomia completa parece ser a opção de tratamento mais eficaz para controlar convulsões não rastreáveis e não passíveis de ressecção focal em crianças.

Keywords

corpus callosotomy - anterior versus complete corpus callosotomy - refractory epilepsy - meta-analysis

Palavras-chave

calosotomia - calosotomia anterior versus completa - epilepsia refratária - metanálise

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