Therapeutic value of patent foramen ovale closure for drug‐resistant epilepsy: A case series report

Author:

Ji Shuming1,Dong Bosi2,Tang Yusha2,Li Hua2,Lai Wanlin2,Li Yajiao3,Chen Yucheng3,Peng Anjiao2,Chen Lei2ORCID

Affiliation:

1. Department of Clinical Research Management West China Hospital of Sichuan University Chengdu China

2. Department of Neurology, West China Hospital, Joint Research Institution of Altitude Health Sichuan University Chengdu China

3. Department of Cardiology West China Hospital of Sichuan University Chengdu China

Abstract

AbstractObjectiveClosure surgery of patent foramen ovale (PFO) has been found to effectively control cryptogenic stroke and migraine, but it is uncertain whether PFO closure could also alleviate epileptic seizures. This study aims to observe the therapeutic effect of PFO closure on epileptic seizures.MethodsSince July 11th, 2017, in the neurology department of West China Hospital, Sichuan University, Chengdu, we have been regularly monitoring patients with epilepsy who have undergone PFO closure. The patient's clinical information, such as frequency, duration, and severity of seizures, before and after surgery was recorded in detail as well as postoperative safety events.ResultsOf the 31 epilepsy patients who confirmed PFO observed (27 cases were drug‐resistant epilepsy, 87.10%), average age of surgery was 23.74 years, and 12 cases were female (38.71%). After one‐year follow‐up, 26 patients (83.87%) achieved remission of seizure frequency, and 22 of whom (70.97%) experienced a remission of more than 50%. Additionally, compared to before surgery, 22 cases (70.97%) reported a decrease in the average seizure duration, and 20 cases (64.52%) reported a reduction in seizure severity. In the seizure indicators of frequency, average duration and severity, significant differences were identified between preoperative and postoperative comparisons with all test p values were <0.05. Furthermore, no serious safety events were reported except for one patient who briefly reported chest pain, and all patients expressed effective PFO closure.SignificanceThe PFO closure has been shown for the first time to result in a significant reduction in the frequency, duration, and severity of seizures. Patients with drug‐resistant epilepsy and PFO with a large shunt are ideal candidates for undergoing PFO closure.Plain Language SummarySince PFO closure was found to have a good therapeutic effect on cryptogenic stroke and migraine, it has become a credible complementary therapy for the treatment of neurological diseases, and drug‐resistant epilepsy with PFO is expected to become the next target disease that PFO closure could significantly improve.

Publisher

Wiley

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