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首页> 外文期刊>Epilepsy & behavior: E&B >Corpus callosotomy versus vagus nerve stimulation for atonic seizures and drop attacks: A systematic review
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Corpus callosotomy versus vagus nerve stimulation for atonic seizures and drop attacks: A systematic review

机译：体切开术与迷走神经刺激治疗失音发作和跌落发作：系统评价

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摘要

Atonic seizures are debilitating and poorly controlled with antiepileptic medications. Two surgical options are primarily used to treat medically refractory atonic seizures: corpus callosotomy (CC) and vagus nerve stimulation (VNS). However, given the uncertainty regarding relative efficacy and surgical complications, the best approach for affected patients is unclear. The PubMed database was queried for all articles describing the treatment of atonic seizures and drop attacks with either corpus callosotomy or VNS. Rates of seizure freedom, >50% reduction in seizure frequency, and complications were compared across the two patient groups. Patients were significantly more likely to achieve a >50% reduction in seizure frequency with CC versus VNS (85.6% versus 57.6%; RR: 1.5; 95% CI: 1.1-2.1). Adverse events were more common with VNS, though typically mild (e.g., 22% hoarseness and voice changes), compared with CC, where the most common complication was the disconnection syndrome (13.2%). Both CC and VNS are well tolerated for the treatment of refractory atonic seizures. Existing studies suggest that CC is potentially more effective than VNS in reducing seizure frequency, though a direct study comparing these techniques is required before a definitive conclusion can be reached. (C) 2015 Elsevier Inc. All rights reserved.
机译：使用抗癫痫药会使无力发作变得虚弱，控制不力。两种外科手术方法主要用于治疗难治性无声的癫痫发作：:体切开术（CC）和迷走神经刺激（VNS）。然而，鉴于相对疗效和手术并发症的不确定性，对于受影响患者的最佳治疗方法尚不清楚。在PubMed数据库中查询所有描述用体切开术或VNS进行无声发作和跌落发作治疗的文章。比较了两个患者组的癫痫发作自由率，癫痫发作频率降低> 50％和并发症。与VNS相比，CC的患者癫痫发作频率降低的可能性更大（分别为85.6％和57.6％; RR：1.5; 95％CI：1.1-2.1）。与CC相比，VNS的不良事件更为常见，尽管通常较轻（例如22％的声音嘶哑和声音变化），而CC的最常见并发症是断开综合征（13.2％）。 CC和VNS均能很好地耐受难治性失聪性癫痫发作。现有研究表明，在减少癫痫发作频率方面，CC可能比VNS更有效，尽管在确定结论之前还需要对这些技术进行直接研究。 （C）2015 Elsevier Inc.保留所有权利。

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