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Research ArticleOriginal Article
Open Access

Efficacy and safety of corpus callosotomy versus vagus nerve stimulation as long-term adjunctive therapies in children with Lennox–Gastaut syndrome

Experience of a tertiary care center

Ghalib M. Alanazi, Turki F. ALOsaimi, Ali H. Alwadei, Ali D. Al-Otaibi, Lamya A. Jad and Alawi A. Al-Attas
Neurosciences Journal April 2022, 27 (2) 59-64; DOI: https://doi.org/10.17712/nsj.2022.2.20210135
Ghalib M. Alanazi
From the Department of Adult Neurology (Al-Attas), Pediatric Neurology Department (Alanazi, Al Osaimi, Alwadei, Al-Otaibi, Jad), National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
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Turki F. ALOsaimi
From the Department of Adult Neurology (Al-Attas), Pediatric Neurology Department (Alanazi, Al Osaimi, Alwadei, Al-Otaibi, Jad), National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
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Ali H. Alwadei
From the Department of Adult Neurology (Al-Attas), Pediatric Neurology Department (Alanazi, Al Osaimi, Alwadei, Al-Otaibi, Jad), National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
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Ali D. Al-Otaibi
From the Department of Adult Neurology (Al-Attas), Pediatric Neurology Department (Alanazi, Al Osaimi, Alwadei, Al-Otaibi, Jad), National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
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Lamya A. Jad
From the Department of Adult Neurology (Al-Attas), Pediatric Neurology Department (Alanazi, Al Osaimi, Alwadei, Al-Otaibi, Jad), National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
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Alawi A. Al-Attas
From the Department of Adult Neurology (Al-Attas), Pediatric Neurology Department (Alanazi, Al Osaimi, Alwadei, Al-Otaibi, Jad), National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
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  • For correspondence: [email protected]
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    Figure 1

    - Improvement (%) during follow-up (months) for the 2 groups. Improvement (%) during follow-up (months) for the 2 groups. VNS - Vagus nerve stimulation, CC - Corpus callosotomy

Tables

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    Table 1

    - Demographic analysis and clinical characteristics of the study subjects.

    Patient characteristicsCorpus callosotomyVNSP-value
    Number of patients54
    Age (years)10.8±1.313.8±3.90.15
    Male/female4/10/40.02
    Age of seizure onset (months)20.6±30.618.8±20.50.68
    Seizure duration before surgery (years)8.2±3.112.0±3.60.13
    Follow-up duration (months)15.2±3.624.5±16.50.25
    Mean age at surgery (years)9.6±1.111.7±3.30.21
    Length of surgery (minutes)291.4±61.6113.75±12.50.002
    Length of hospitalization (days)9.6±4.47.25±3.50.41
    Main seizure types
    Atonic/tonic with head drops52
    Generalized tonic seizure01
    Generalized tonic–clonic seizure01
    MRI findings
    Atrophic change02
    Pachygyria–lissencephaly with band heterotopias10
    Normal42
    Number of antiepileptic medications
    Before surgery3.4±1.13.5±1.30.91
    After surgery3.4±1.13.0±1.1
    Change in antiepileptic medications
    Not changed330.5
    Increased00 
    Decreased21 

    VNS - Vagus nerve stimulation

      • View popup
      Table 2

      - Comparison of seizure reduction rates (all seizure types) and documented complications of patients treated with corpus callosotomy and vagal nerve stimulation.

      Seizure reduction rateCorpus callosotomyVNSComparison p-value
      >75%220.64
      >51–74%100.34
      ≤50%220.83
      Complications1/51/4
      Cerebrospinal fluid100.72
      Swallowing difficulty01
      No43

      VNS - Vagus nerve stimulation

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      Efficacy and safety of corpus callosotomy versus vagus nerve stimulation as long-term adjunctive therapies in children with Lennox–Gastaut syndrome
      Ghalib M. Alanazi, Turki F. ALOsaimi, Ali H. Alwadei, Ali D. Al-Otaibi, Lamya A. Jad, Alawi A. Al-Attas
      Neurosciences Journal Apr 2022, 27 (2) 59-64; DOI: 10.17712/nsj.2022.2.20210135

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      Efficacy and safety of corpus callosotomy versus vagus nerve stimulation as long-term adjunctive therapies in children with Lennox–Gastaut syndrome
      Ghalib M. Alanazi, Turki F. ALOsaimi, Ali H. Alwadei, Ali D. Al-Otaibi, Lamya A. Jad, Alawi A. Al-Attas
      Neurosciences Journal Apr 2022, 27 (2) 59-64; DOI: 10.17712/nsj.2022.2.20210135
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