A prospective study to cmpare surgical treatment and anti-epileptic drug treatment in school age chidren with Lennox-Gastant syndrome

Objective To compare outcomes of anterior corpus callosotomy (CCT) with anti-epileptic drug treatment in school-aged children with Lennox-Gastaut syndrome (LGS).Methods To prospectively enroll 60 school-aged children with LGS,who were divided into medicine group and surgery group.Thirty seven cases in medicine group were treated with rational multiple anti-epilepsy drugs,and 23 cases in surgery group underwent anterior CCT.Seizures control at 1-5 years follow-up after enrollment and changes of intelligence quotient (IQ) and quality of life (QOL) from pre-treatment to 2 years follow-up were comparedbetweenthe two groups.Results All patients ofsurgery group and 33 cases ofmedical group finished 1-5 years follow-up.The percentages of total seizure-free in surgery group were 17.4％ at 1 year follow-up,13.0％ at 2 years follow-up and 8.7％,and the data were 5.9％,2.9％ and 2.9％ in medicine group respectively.Significant differences (P ＜0.05) in total seizure control,tonic,tonic-clonic and atypical absence seizure were found between two groups at 1 year,2 years,and 5 years follow-ups.The significant differences(P ＜0.01) were found in mean changes of IQ and overall QOL between medicine group and surgical group at 2 years follow-up,and mean changes of IQ and QOL from surgery group were positive which was not related to postoperative outcomes of seizure control(P ＞ 0.05).Conclusions Anterior CCT is promising for school-aged children with LGS,and can present obvious seizure control and QOL and IQ improvements,which were better than multiple anti-epilepsy drugs treatment significantly. Key words: Epileptic surgery;  School-aged children;  Anterior corpus callosotomy ;  Lennox-Gastaut syndrome;  Controlled study