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Hemispherectomy

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https://www.readbyqxmd.com/read/28300030/hemispheric-polymicrogyria-and-neonatal-seizures-a-potentially-life-threatening-combination
#1
Paula M Brna, A Simon Harvey, Richard J Leventer
Polymicrogyria (PMG) is a heterogeneous malformation of cortical development characterized by excessive gyration and abnormal cortical lamination. Typically, bilateral forms have more severe developmental delay and early-onset epilepsy, but the full spectrum of severity remains ill-defined. We report two cases of right hemispheric PMG and neonatal-onset, drug-resistant seizures culminating in early death. Case 1 began having seizures on Day 1 of life that intensified in severity and proved resistant to numerous antiepileptic drugs...
March 14, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28291425/long-term-outcomes-of-epilepsy-surgery-in-85-pediatric-patients-followed-up-for-over-10-years-a-retrospective-survey
#2
Hiroshi Hosoyama, Kazumi Matsuda, Tadahiro Mihara, Naotaka Usui, Koichi Baba, Yushi Inoue, Takayasu Tottori, Toshiaki Otsubo, Yumi Kashida, Koji Iida, Hirofumi Hirano, Ryosuke Hanaya, Kazunori Arita
OBJECTIVE The aim of this study was to investigate the treatment outcomes and social engagement of patients who had undergone pediatric epilepsy surgery more than 10 years earlier. METHODS Between 1983 and 2005, 110 patients younger than 16 years underwent epilepsy surgery at the National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders. The authors sent a questionnaire to 103 patients who had undergone follow-up for more than 10 years after surgery; 85 patients (82.5%) responded. The survey contained 4 categories: seizure outcome, use of antiepileptic drugs, social participation, and general satisfaction with the surgical treatment (resection of the epileptic focus, including 4 hemispherectomies)...
March 3, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28254429/normal-language-in-abnormal-brains
#3
REVIEW
Massimo Piattelli-Palmarini
There is little doubt that, in the adult, specific brain lesions cause specific language deficits. Yet, brain localizations of linguistic functions are made problematic by several reported cases of normal language in spite of major brain anomalies, mostly, but not exclusively, occurring early in life. The signal cases are hydrocephaly, spina bifida and hemispherectomy. These cases are discussed and possible solutions are suggested: namely a vast redundancy of neurons and/or the role of microtubules as neuron-internal processors and key factors in signaling and guiding the growth and reconfiguration of the brain...
February 27, 2017: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/28237414/visual-function-twenty-years-after-childhood-hemispherectomy-for-intractable-epilepsy
#4
Sian E Handley, Faraneh Vargha-Khadem, Richard J Bowman, Alki Liasis
PURPOSE: To investigate visual function in adults post hemispherectomy in childhood. DESIGN: Non-comparative case series. METHODS: All participants underwent visual acuity, binocular function, visual field, optical coherence tomography (OCT) of the retinal nerve fiber layer (RNFL), and monocular pattern reversal visually evoked potentials (prVEP). PARTICIPANTS: 6 adults who had a hemispherectomy in childhood (median 21...
February 22, 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/27916450/dramatic-response-after-functional-hemispherectomy-in-a-patient-with-epileptic-encephalopathy-carrying-a-de-novo-col4a1-mutation
#5
Naomi Hino-Fukuyo, Atsuo Kikuchi, Masaki Iwasaki, Yuko Sato, Yuki Kubota, Tomoko Kobayashi, Tojo Nakayama, Kazuhiro Haginoya, Natsuko Arai-Ichinoi, Tetsuya Niihori, Ryo Sato, Tasuku Suzuki, Hiroki Kudo, Ryo Funayama, Keiko Nakayama, Yoko Aoki, Shigeo Kure
We describe the first case of a successful functional hemispherectomy in a patient with epileptic encephalopathy and a de novo collagen type IV alpha 1 (COL4A1) mutation. A 4-year-old girl was COL4A1 mutation-positive and suffered from drug-resistant epilepsy, hemiplegia, and developmental delay. Magnetic resonance imaging detected no porencephaly, and she had no cataract or renal abnormality. Following a presurgical evaluation for epilepsy, she underwent a functional hemispherectomy. She has been seizure free with no intracranial hemorrhage or other perioperative complications...
December 1, 2016: Brain & Development
https://www.readbyqxmd.com/read/27834621/repeat-surgery-for-focal-cortical-dysplasias-in-children-indications-and-outcomes
#6
Matthew F Sacino, Cheng-Ying Ho, Matthew T Whitehead, Amy Kao, Dewi Depositario-Cabacar, John S Myseros, Suresh N Magge, Robert F Keating, William D Gaillard, Chima O Oluigbo
OBJECTIVE Focal cortical dysplasia (FCD) is a common cause of medically intractable epilepsy that often may be treated by surgery. Following resection, many patients continue to experience seizures, necessitating a decision for further surgery to achieve the desired seizure outcomes. Few studies exist on the efficacy of reoperation for intractable epilepsy due to FCD in pediatric cohorts, including the definition of prognostic factors correlated with clinical benefit from further resection. METHODS The authors retrospectively analyzed the medical records and MR images of 22 consecutive pediatric patients who underwent repeat FCD resection after unsuccessful first surgery at the Children's National Health System between March 2005 and April 2015...
February 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27818366/aicardi-syndrome-epilepsy-surgery-as-a-palliative-treatment-option-for-selected-patients-and-pathological-findings
#7
Irina Podkorytova, Ajay Gupta, Elaine Wyllie, Ahsan Moosa, William Bingaman, Richard Prayson, Elia M Pestana Knight
The optimal treatment for medically refractory epilepsy in Aicardi syndrome (AS) is still unclear. Palliative surgical treatment, including vagus nerve stimulation and corpus callosotomy, has therefore been used. There is limited data on the role of resective epilepsy surgery as a treatment choice in patients with AS. Here, we describe the seizures, anatomo-pathological findings, and neurodevelopmental outcome of palliative epilepsy surgery in two children with AS who had resective epilepsy surgery at the Cleveland Clinic...
December 1, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/27796549/-endovascular-embolic-hemispherectomy-a-strategy-for-the-initial-management-of-catastrophic-holohemispheric-epilepsy-in-the-neonate
#8
Chima Oluigbo, Monica S Pearl, Tammy N Tsuchida, Taeun Chang, Cheng-Ying Ho, William D Gaillard
PURPOSE: Conflicting challenges abound in the management of the newborn with intractable epilepsy related to hemimegalencephaly. Early hemispherectomy to stop seizures and prevent deleterious consequences to future neurocognitive development must be weighed against the technical and anesthetic challenges of performing major hemispheric surgery in the neonate. METHODS: We hereby present our experience with two neonates with hemimegalencephaly and intractable seizures who were managed using a strategy of initial minimally invasive embolization of the cerebral blood supply to the involved hemisphere...
October 29, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27791704/impact-of-intraoperative-3-t-mri-with-diffusion-tensor-imaging-on-hemispherectomy
#9
Gun-Ha Kim, Joo Hee Seo, Seema Schroff, Po-Ching Chen, Ki Hyeong Lee, James Baumgartner
OBJECTIVE Hemispherectomy can produce remarkable seizure control of medically intractable hemispheric epilepsy in children, but some patients continue to have seizures after surgery. A frequent cause of treatment failure is incomplete surgical disconnection of the abnormal hemisphere. This study explores whether intraoperative 3-T MRI with diffusion tensor imaging (DTI) during hemispherectomy can identify areas of incomplete disconnection and allow complete disconnection during a single surgery. METHODS The charts of 32 patients with epilepsy who underwent hemispherectomy between January 2012 and July 2014 at the Florida Hospital for Children were reviewed...
January 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27618602/long-term-effect-of-rituximab-in-a-case-with-late-onset-rasmussen%C3%A2-s-encephalitis-with-anti-ganglioside-iggq1b-and-anti-gad-antibodies-positivity-case-report
#10
Gabriela Timarova, Iveta Lisa, Peter Kukumberg
Rasmussen's encephalitis is a rare autoimmune encephalitis usually involving one brain hemisphere, presenting with refractory epileptic seizures, and neurological and cognitive decline. Only 10% of cases start later in adolescence/adulthood. The only effective treatment for refractory seizures in childhood is hemispherectomy. For late-onset cases with mild neurological deficit the hemispherectomy is usually postponed because of its severe consequences. Immunotherapy shows some temporal effect for seizure control and slowing the brain atrophy, mainly in late onset Rasmussen's encephalitis...
July 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/27606645/epilepsy-surgery-in-children-and-adolescents-report-on-43-cases
#11
Marina Aberastury, Betina Comas, María García, Ana Besocke, Carlos Ciraolo, Guillermo Agosta, Walter Silva
Epilepsy surgery in children with refractory epilepsy is one of the most effective methods to control seizures. The proper selection and assessment of surgery candidates is critical for surgical treatment to be adequately effective and safe. The purpose of this article is to describe our experience with 43 consecutive pediatric patients that underwent epilepsy surgery for refractory epilepsy between September 2005 and May 2014. Effectiveness, safety, and prognostic factors were analyzed. The median age was 12 years old at the time of surgery and 4...
October 1, 2016: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/27596103/current-treatment-options-for-early-onset-pediatric-epileptic-encephalopathies
#12
REVIEW
Rolla Shbarou
The management of early-onset, genetically determined epilepsies is often challenging. First-line anti-epileptic drugs (AEDs) often include phenobarbital, phenytoin, oxcarbazepine, carbamazepine, clonazepam, levetiracetam, and valproic acid. Combinations of medications are used in these patients with often intractable seizures, and they include topiramate, clobazam, felbamate, lacosamide, lamotrigine, rufinamide, vigabatrin, ACTH, oral steroids, and the ketogenic diet. Vagus nerve stimulator therapy offers some relief in selected patients...
October 2016: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/27573872/when-left-hemisphere-reading-is-compromised-comparing-reading-ability-in-participants-after-left-cerebral-hemispherectomy-and-participants-with-developmental-dyslexia
#13
Tami Katzir, Joanna A Christodoulou, Stella de Bode
OBJECTIVE: We investigated reading skills in individuals who have undergone left cerebral hemispherectomy and in readers with developmental dyslexia to understand diverse characteristics contributing to reading difficulty. Although dyslexia is a developmental disorder, left hemispherectomy requires that patients (re)establish the language process needed to perform the language-based tasks in the nondominant (right) hemisphere to become readers. METHODS: Participants with developmental dyslexia (DD; n = 11) and participants who had undergone left hemispherectomy (HEMI; n = 11) were matched on age and gender, and were compared on timed and untimed measures of single word and pseudo-word reading...
October 2016: Epilepsia
https://www.readbyqxmd.com/read/27555151/prophylactic-use-of-tranexamic-acid-combined-with-thrombelastogram-guided-coagulation-management-may-reduce-blood-loss-and-allogeneic-transfusion-in-pediatric-hemispherectomy-case-series
#14
Wei Xiao, Wenya Fu, Tianlong Wang, Lei Zhao
Hemispherectomy is an established surgical procedure to treat medically refractory epilepsy caused by diffuse hemispheric diseases. The most common complication of hemispherectomy is intraoperative bleeding. Perioperative allogeneic blood transfusion increases mortality and morbidity in pediatric patients. Etiologies of massive blood loss during hemispherectomy include intraoperative diffuse vascular damage, antileptic drugs induced coagulation dysfunction, hyperfibrinolysis and dilutional coagulopathy. Great efforts should be made to minimize the need of blood transfusion...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27544471/current-and-emerging-surgical-therapies-for-severe-pediatric-epilepsies
#15
Carrie R Muh
The use of epilepsy surgery in various medically resistant epilepsies is well established. For patients with intractable pediatric epilepsy, the role of intracranial electrodes, resective surgery, hemispherectomy, corpus callosotomy, neurostimulation, and multiple subpial transections continues to be very effective in select cases. Newer treatment and diagnostic methods include laser thermal ablation, minimally invasive surgeries, stereo electroencephalography, electrocorticography, and other emerging techniques...
May 2016: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/27383529/predicting-hand-function-after-hemidisconnection
#16
Hanna Küpper, Manfred Kudernatsch, Tom Pieper, Samuel Groeschel, Jacques-Donald Tournier, David Raffelt, Peter Winkler, Hans Holthausen, Martin Staudt
Hemidisconnections (i.e. hemispherectomies or hemispherotomies) invariably lead to contralateral hemiparesis. Many patients with a pre-existing hemiparesis, however, experience no deterioration in motor functions, and some can still grasp with their paretic hand after hemidisconnection. The scope of our study was to predict this phenomenon. Hypothesizing that preserved contralateral grasping ability after hemidisconnection can only occur in patients controlling their paretic hands via ipsilateral corticospinal projections already in the preoperative situation, we analysed the asymmetries of the brainstem (by manual magnetic resonance imaging volumetry) and of the structural connectivity of the corticospinal tracts within the brainstem (by magnetic resonance imaging diffusion tractography), assuming that marked hypoplasia or Wallerian degeneration on the lesioned side in patients who can grasp with their paretic hands indicate ipsilateral control...
September 2016: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/27377225/functional-hemispherectomy-for-refractory-status-epilepticus-in-2-adults
#17
Michael McGinity, Nicholas Andrade, Kameel Karkar, Jean-Louis Caron, Charles Szabó, Alexander Papanastassiou
BACKGROUND: Status epilepticus (SE) is a medical emergency, as deleterious long-term effects are well known. Medically induced burst suppression is often required if first-line and second-line treatments fail. Surgical intervention can be considered in some patients after prolonged treatment failure of medically induced coma. Multiple surgical options for terminating SE have been demonstrated in the literature, with only 2 reports including hemispherectomy in adults. CASE DESCRIPTION: We present 2 cases of adults with refractory SE who failed more conservative medical/surgical treatment but responded to functional hemispherectomy...
September 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27375761/hemispherectomy-procedure-in-proteus-syndrome
#18
PrastiyaIndra Gunawan, Lusiana Lusiana, Darto Saharso
Objective Proteus syndrome is a rare overgrowth disorder including bone, soft tissue, and skin. Central nervous system manifestations were reported in about 40% of the patients including hemimegalencephaly and the resultant hemicranial hyperplasia, convulsions and mental deficiency. We report a 1-month-old male baby referred to Pediatric Neurology Clinic Soetomo Hospital, Surabaya, Indonesia in 2014 presented recurrent seizures since birth with asymmetric dysmorphic face with the right side larger than the left, subcutaneous mass and linear nevi...
2016: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/27341359/significance-of-the-feuerstein-approach-in-neurocognitive-rehabilitation
#19
Jo Lebeer
BACKGROUND: The theory of Structural Cognitive Modifiability and Mediated Learning Experience of Reuven Feuerstein states that individuals with brain impairment, because of congenital or acquired origin, may substantially and structurally improve their cognitive functioning, by a systematic intervention based on a specific, criteria-based type of interaction ("mediated learning"). Three application systems are based on it: a dynamic-interactive assessment of learning capacity and processes of learning, the LPAD (Learning Propensity Assessment Device); a cognitive intervention program called "Instrumental Enrichment Program", which trains cognitive, metacognitive and executive functions; and a program, which is oriented at working in context, Shaping Modifying Environments...
June 18, 2016: NeuroRehabilitation
https://www.readbyqxmd.com/read/27322806/volumetric-analysis-of-cerebral-peduncles-and-cerebellar-hemispheres-for-predicting-hemiparesis-after-hemispherectomy
#20
Jeffrey P Mullin, Pranay Soni, Sungho Lee, Lara Jehi, Ahsan Moosa Naduvil Valappi, William Bingaman, Jorge Gonzalez-Martinez
BACKGROUND: In some cases of refractory epilepsy, hemispherectomy is the final invasive treatment option. However, predictors of postoperative hemiparesis in these patients have not been widely studied. OBJECTIVE: To investigate how the volumetric analysis of cerebral peduncles and cerebellar hemispheres in patients who have undergone hemispherectomy may determine prognostic implications for postoperative hemiparesis. METHODS: Twenty-two patients who underwent hemispherectomy at our institution were retrospectively included...
September 2016: Neurosurgery
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