Purpose: We analyzed the surgical indications, outcomes, and prognostic factors of subtotal hemispherotomy for intractable lesional hemispheric epilepsy in children with almost normal motor function and summarized its surgical strategies.
Methods: We retrospectively analyzed 20 children who underwent subtotal hemispherotomy (hemispheric disconnection sparing sensorimotor cortex) between March 2015 and May 2021. The children were divided into seizure-free group and residual seizures group according to their surgical outcomes. The surgical outcome was based on International League Against Epilepsy (ILAE) classification (class 1-6). All presurgical evaluation data were collected and analyzed.
Results: Among the 20 children, the mean age at the time of seizure onset, mean age at the time of surgery, and mean follow-up time was 3.2 ± 2.8, 7.5 ± 4.4, and 3.5 ± 2.1 years, respectively. All children had hemispheric lesion on MRI. At the last follow-up evaluation, 75% (15/20) of children remained seizure-free. Univariate analyses revealed that the electrocorticogram finding of epileptiform discharges in the central cortex after disconnection were poor prognostic factors for seizure outcomes (P < 0.05). Disconnection of the central operculum and insula was a poor prognostic factor for motor function after surgery (P < 0.05).
Conclusions: For intractable lesional hemispheric epilepsy with no hemiparesis, subtotal hemispherotomy can be performed with favorable seizure outcome. Disconnection of the central operculum and insula may increase the possibility of motor function injury.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.eplepsyres.2022.106973 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The long-term outcomes in drug-resistant epilepsy patients who underwent subtotal hemispherotomy: A single-center retrospective cohort study.
Clin Neurol Neurosurg
October 2024
Functional Neurosurgery Department, Sanbo Brain Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Clinical Research on Epilepsy, Beijing, China; Centre of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China. Electronic address:
Article Synopsis
- * Results showed that 68% of patients became seizure-free after surgery, with most experiencing no significant changes in motor function, though some did face new motor deficits.
- * Prognostic factors indicated that older age at surgery, presence of post-operative seizures, and certain brain area resections were linked to worse seizure and motor function outcomes.
Reply to: "How to disconnect the splenium and fornix in posterior quadrant disconnection, hemispherotomy, and subtotal hemispherotomy".
Acta Neurochir (Wien)
March 2023
Neurodynamics Laboratory, Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
How to disconnect the splenium and fornix in posterior quadrant disconnection, hemispherotomy, and subtotal hemispherotomy.
Acta Neurochir (Wien)
March 2023
Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan.
Comparing late-onset epileptic spasm outcomes after corpus callosotomy and subsequent disconnection surgery between post-encephalitis/encephalopathy and non-encephalitis/encephalopathy.
Epilepsia Open
June 2023
Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Objective: We aimed to analyze the efficiency of corpus callosotomy (CC) and subsequent disconnection surgeries in patients with late-onset epileptic spasms (LOES) by comparing post-encephalitis/encephalopathy (PE) and non-encephalitis/encephalopathy (NE). We hypothesized these surgeries can control potential focal onset epileptic spasms (ES) in the NE group but not in the PE group.
Methods: We retrospectively included 23 patients (12 with PE and 11 with NE) who initially underwent CC and subsequent disconnection surgeries (five NE).
Subtotal hemispherotomy for intractable lesional hemispheric epilepsy without hemiparesis in children.
Epilepsy Res
September 2022
Pediatric Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, Xicheng District, Beijing 100034, China. Electronic address:
Purpose: We analyzed the surgical indications, outcomes, and prognostic factors of subtotal hemispherotomy for intractable lesional hemispheric epilepsy in children with almost normal motor function and summarized its surgical strategies.
Methods: We retrospectively analyzed 20 children who underwent subtotal hemispherotomy (hemispheric disconnection sparing sensorimotor cortex) between March 2015 and May 2021. The children were divided into seizure-free group and residual seizures group according to their surgical outcomes.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!