Síndrome de Lennox-Gastaut y tratamiento quirúrgico paliativo: Revisión bibliográfica

Abstract

Introduction: Lennox-Gastaut Syndrome (LGS) is one of the most severe forms of epilepsy in childhood due to the high frequency of seizures, drug resistance and associative frequency with cognitive impairment. The most common epileptic seizures are tonic, atonic and atypical absences, but other types can coexist. Palliative surgical treatment of LGS consists of performing callosotomy or vagus nerve stimulation (VNS). Objective: Review which palliative treatment for LGS, such as callosotomy and vagus nerve stimulation, that performs a better response in the remission of seizures. Methods: Bibliographic review of PubMed, LILACS, SciELO and CAPES Journal Platform. It was chosen articles mainly in English, published since 2000 and covering the palliative surgical treatment of LGS. The collected data were organized in tables. Results: 17 articles were selected, 8 were about callosotomy and 9 about VNS. Regarding callosotomy, a response was evaluated in 327 patients, and the state of free epileptic seizures was reached in 74 patients (22.62%). While an improvement of more than 50% occurred in 70.84% of the patients. Regarding VNS, 9 articles were selected, totaling 983 patients. They obtained a reduction of more than 50% of the seizures in 57,8% of them. Conclusion: Both procedures are effective in decreasing the frequency and severity of seizures in LGS. Callosotomy appears to be more effective in decreasing atonic attacks. In the articles evaluated, there was no difference in the reduction of all types of seizures.