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Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2015; 34(04): 304-308
DOI: 10.1055/s-0035-1564581
Review Article | Artigo de Revisão
Thieme Publicações Ltda Rio de Janeiro, Brazil

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

Controle das crises epilépticas após calosotomia anterior versus completa em crianças: uma revisão sistemática com metanálise
Lucas Crociati Meguins
1   Neurosurgery Division, Hospital de Base, Department of Neurologic Sciences, Faculdade de Medicina de São José do Rio Preto (FAMERP), SP, Brazil
,
Rodrigo Antônio Rocha da Cruz Adry
1   Neurosurgery Division, Hospital de Base, Department of Neurologic Sciences, Faculdade de Medicina de São José do Rio Preto (FAMERP), SP, Brazil
,
Sebastião Carlos da Silva Júnior
1   Neurosurgery Division, Hospital de Base, Department of Neurologic Sciences, Faculdade de Medicina de São José do Rio Preto (FAMERP), SP, Brazil
,
Carlos Umberto Pereira
2   Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brazil
,
Jean Gonçalves de Oliveira
3   Division of Neurosurgery, Department of Medical Sciences, School of Medicine, Universidade Nove de Julho; Department of Cerebrovascular and Skull Base surgery, Center of Neurology and Neurosurgery Associates, Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil
,
Dionei Freitas de Morais
1   Neurosurgery Division, Hospital de Base, Department of Neurologic Sciences, Faculdade de Medicina de São José do Rio Preto (FAMERP), SP, Brazil
,
Gerardo Maria de Araújo Filho
4   Department of Psychiatry and Medical Psychology, FAMERP, SP, Brazil
,
Lúcia Helena Neves Marques
5   Neurologic Division, Hospital de Base, Department of Neurologic Sciences, FAMERP, SP, Brazil
› Author Affiliations
Further Information

Publication History

10 November 2013

07 August 2015

Publication Date:
20 October 2015 (online)

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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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