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Vol. 1. Issue 6.
Pages 345-350 (January 1990)
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Vol. 1. Issue 6.
Pages 345-350 (January 1990)
La callosotomía en el tratamiento de algunas formas de epilepsia: Resultados y problemas prácticos
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I. Papo, F. Rychlicki
Servicio de Neurocirugía. Hospital General Regional
A. Quattrini*, A. Paggi*, A. Ortenzi*, M. Del Pesce**, L. Provinciali**
* Centro para la cura de la Epilepsia. Hospital General Regional
** Clínica Neurológica de la Universidad. Ancona. Italia
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Resumen

Los autores resumen su experiencia con referencia al tratamiento mediante sección completa, subtotal o parcial (anterior) del cuerpo calloso en 20 epilépticos con manifestaciones comiciales polimorfas fármacoresistentes, en los cuales las crisis atónico-hipertónicas con brusca caida y frecuentes traumas craneales constituían el elemento predominante.

El seguimiento post-operatorio medio fue de 33,8 meses.

A la luz de un seguimiento más prolongado, los resultados conseguidos parecen algo inferiores a los· relatados en trabajos personales publicados con anterioridad, pues se lamentan algunas recidivas, aunque en forma atenuada, tras callosotomía anterior o subtotal. Sin embargo, los resultados siguen siendo satisfactorios o muy satisfactorios en un 60% de los operados, además en otro 20% se consiguió una disminución considerable de la frecuencia de las crisis.

La experiencia relatada parece sugerir que la callosotomía total en dos tiempos debería tal vez tomarse con más frecuencia en consideración sobre todo en los síndromes de Lennox-Gastaut con QI bajo, en los que no cabe esperar ulteriores trastornos neuropsicológicos.

Summary

The authors summarise the results obtained with callosotomy, whether total or partial, in 20 patients suffering from long-standing drug-resistant multifocal epilepsy.

In all patients exbibiting protean seizures, the atonichypertonic ones with sudden fall and frequent head injuries were the most disabling. The average postoperative follow-up was 33,8 months. The results of partial or subtotal commisurotomies at a longer follow-up seems to be somewhat less satisfactory than in previous personal reports due to some relapses.

However, atonic-hypertonic fits are still satisfactorily controlled in about 60% of the patients. Furthermore, significant relief was attained in additional 20% of cases.

From the reported overall experience it would appear that two-staged complete callosotomy might be more often taken into account by first intention, mostly in patient with low IQ in whom further neuropsychological disorders are not to be expected.

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