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JOURNAL ARTICLE
Keshav Goel, H Westley Phillips, Jia-Shu Chen, Jacqueline Ngo, Benjamin Edmonds, Phong X Ha, Andrew Wang, Alexander Weil, Bianca E Russell, Noriko Salamon, Hiroki Nariai, Aria Fallah
OBJECTIVES: Hemimegalencephaly (HME) is a rare congenital brain malformation predominantly presenting with drug-resistant epilepsy. Hemispheric disconnective surgery is the mainstay of treatment, however, little is known about how postoperative outcomes compare across techniques. Thus, we present the largest single-center cohort of patients with HME who underwent epilepsy surgery and characterize outcomes. METHODS: This observational study included patients with HME at UCLA from 1984-2021...
October 24, 2023: Epilepsia
#22
JOURNAL ARTICLE
Daiana R Pur, Gayathri K Sivakumar, Lulu L C D Bursztyn, Yiannis Iordanous, Sandrine de Ribaupierre
BACKGROUND: Children undergoing hemispheric surgery for intractable seizures are susceptible to visual complications including strabismus. This systematic review aims to investigate the rates and characteristics of strabismus development after hemispheric surgery and evaluate clinical implications for ophthalmologic care. METHODS: A systematic search of MEDLINE, EMBASE, Cochrane, PsychINFO, and Web of Science databases was performed from database inception to May 2022...
August 25, 2023: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
#23
JOURNAL ARTICLE
D Chiarello, G Tumminelli, F Sandrin, C Vilasi, L Castana, G Lo Russo, A Liava, S Francione
INTRODUCTION: Only a few studies have focused on tailored resection in post-stroke epilepsy, in which hemispherectomy and hemispherotomy are the most recognized treatments. CASE DESCRIPTION: We describe the case of a patient with drug-resistant, presumed perinatal, post-stroke epilepsy and moderate right hemiparesis. The seizures were stereotyped, both spontaneous and induced by sudden noises and somatosensory stimuli. Considering the discordant anatomic-electro-clinical data - left perisylvian malacic lesion with electrical onset over the left mesial fronto-central leads - and the patient's functional preservation, SEEG was performed...
2023: Epilepsy & behavior reports
#24
JOURNAL ARTICLE
Ranjith Kumar Manokaran, Ivanna Yau, Robyn Whitney, Ayako Ochi, Hiroshi Otsubo, Elysa Widjaja, George M Ibrahim, Elizabeth J Donner, Puneet Jain
PURPOSE: Hippocampal Sclerosis (HS) may co-exist with temporal or extratemporal lesions (dual pathology) in children and is usually ipsilateral to the radiological lesion. Here were report three cases with extensive hemispheric cortical malformation and drug resistant epilepsy who had persistent seizures after functional hemispherectomy (FH) and developed contralateral HS after the surgery. METHODS: This retrospective study enrolled children who underwent FH and developed contralateral HS after surgery...
October 2023: Seizure: the Journal of the British Epilepsy Association
#25
JOURNAL ARTICLE
Brenda Cristina Nava, Ursula Thome Costa, Ana Paula Andrade Hamad, Camila Araujo Bernardino Garcia, Americo Ceiki Sakamoto, Davi Casale Aragon, Helio Rubens Machado, Marcelo Volpon Santos
OBJECTIVE: Rasmussen Encephalitis (RE) is a rare inflammatory neurodegenerative disease associated with refractory seizures, hemiparesis, and cognitive deterioration, due to lateralized cortical atrophy. Hemispheric surgery (hemispherotomy) is the mainstay of treatment, but its unavoidable motor deficits and lack of long-term data regarding seizure outcomes can make patients and families apprehensive to undergo this procedure. The present study aimed at analyzing the results of surgical treatment for RE from a motor and epilepsy standpoint, and mitigate such concerns...
August 17, 2023: Epileptic Disorders: International Epilepsy Journal with Videotape
#26
Vladislav Ayzenberg, Michael C Granovetter, Sophia Robert, Christina Patterson, Marlene Behrmann
Hemispherectomy is a surgical procedure in which an entire hemisphere of a patient's brain is resected or functionally disconnected to manage seizures in individuals with drug-resistant epilepsy. Despite the extensive loss of input from both ventral and dorsal visual pathways of one hemisphere, pediatric patients who have undergone hemispherectomy show a remarkably high degree of perceptual function across many domains. In the current study, we sought to understand the extent to which functions of the ventral and dorsal visual pathways reorganize to the contralateral hemisphere following childhood hemispherectomy...
August 5, 2023: bioRxiv
#27
JOURNAL ARTICLE
Andrew T Hale, Dagoberto Estevez-Ordonez, Jana Badrani, Wen Sha, Anastasia Arynchyna-Smith, Monisha Goyal, Ismail Mohamed, Pongkiat Kankirawatana, Curtis J Rozzelle, Jeffrey P Blount
OBJECTIVE: Hemispherectomy is highly effective for patients with medically refractory epilepsy (MRE) arising from a single hemisphere. Recently, the Hemispherectomy Outcome Prediction Scale (HOPS) was developed as a prediction tool for seizure freedom after hemispherectomy. The authors' goal was to perform a validation study to determine the generalizability of the HOPS score. METHODS: The authors present an observational, retrospective, 20-year, single-institution, two-surgeon experience using the lateral peri-insular hemispherectomy approach to validate the HOPS score...
October 1, 2023: Journal of Neurosurgery. Pediatrics
#28
JOURNAL ARTICLE
Morgan Day, Robbin Gibb, Bryan Kolb
After large neocortical lesions, such as hemidecortication, children can show significant motor and cognitive impairments. It thus is of considerable interest to identify treatments that might enhance long-term functional outcome. We have previously shown that tactile stimulation enhances recovery from perinatal focal cortical lesions in rats, so the goal of the present experiment was to explore the effectiveness of postlesion tactile stimulation in reducing functional deficits associated with neonatal hemidecortication...
July 15, 2023: Behavioural Brain Research
#29
JOURNAL ARTICLE
Stephanie C DeLuca, Mary Rebekah Trucks, Dorian Wallace, Sharon Landesman Ramey
Intensive therapies have become increasingly popular for children with hemiparesis in the last two decades and are specifically recommended because of high levels of scientific evidence associated with them, including multiple randomized controlled trials and systematic reviews. Common features of most intensive therapies that have documented efficacy include: high dosages of therapy hours; active engagement of the child; individualized goal-directed activities; and the systematic application of operant conditioning techniques to elicit and progress skills with an emphasis on success-oriented play...
June 7, 2023: Behavioral Sciences
#30
JOURNAL ARTICLE
Alexander G Weil, Evan Dimentberg, Evan Lewis, George M Ibrahim, Olivia Kola, Chi-Hong Tseng, Jia-Shu Chen, Kao-Min Lin, Li-Xin Cai, Qing-Zhu Liu, Jiu-Luan Lin, Wen-Jing Zhou, Gary W Mathern, Matthew D Smyth, Brent R O'Neill, Roy Dudley, John Ragheb, Sanjiv Bhatia, Daniel Delev, Georgia Ramantani, Josef Zentner, Anthony C Wang, Christian Dorfer, Martha Feucht, Thomas Czech, Robert J Bollo, Galymzhan Issabekov, Hongwei Zhu, Mary Connolly, Paul Steinbok, Jian-Guo Zhang, Kai Zhang, Eveline Teresa Hidalgo, Howard L Weiner, Lily Wong-Kisiel, Samuel Lapalme-Remis, Manjari Tripathi, P Sarat Chandra, Walter Hader, Feng-Peng Wang, Yi Yao, Pierre Olivier Champagne, Tristan Brunette-Clément, Qiang Guo, Shao-Chun Li, Marcelo Budke, Maria Angeles Pérez-Jiménez, Christian Raftopoulos, Patrice Finet, Pauline Michel, Karl Schaller, Martin N Stienen, Valentina Baro, Christian Cantillano Malone, Juan Pociecha, Noelia Chamorro, Valeria L Muro, Marec von Lehe, Silvia Vieker, Chima Oluigbo, William D Gaillard, Mashael Al Khateeb, Faisal Al Otaibi, Niklaus Krayenbühl, Jeffrey Bolton, Phillip L Pearl, Aria Fallah
OBJECTIVES: Although hemispheric surgeries are among the most effective procedures for drug-resistant epilepsy (DRE) in the pediatric population, a large variability in outcomes remains. Identifying ideal hemispherectomy candidates is imperative to maximize the potential for seizure freedom. The objective was to develop an online, freely-accesible tool that accurately predicts the probability of seizure freedom for any patient at 1-, 2-, and 5-years post-hemispherectomy to provide clinicians accessible and reliable prognostic information to complement clinical judgement...
June 22, 2023: Epilepsia
#31
JOURNAL ARTICLE
Lisa F Akiyama, Emma A Roberts, Hillary A Shurtleff, Dwight Barry, Russell P Saneto, Edward J Novotny, Christopher C Young, Molly H Warner, Jason S Hauptman, Jeffrey G Ojemann, Ahmad Marashly
OBJECTIVE: Epilepsy surgery remains one of the most underutilized procedures in epilepsy despite its proven superiority to other available therapies. This underutilization is greater in patients in whom initial surgery fails. This case series examined the clinical characteristics, reasons for initial surgery failure, and outcomes in a cohort of patients who underwent hemispherectomy following unsuccessful smaller resections for intractable epilepsy (subhemispheric group [SHG]) and compared them to those of a cohort of patients who underwent hemispherectomy as the first surgery (hemispheric group [HG])...
June 2, 2023: Journal of Neurosurgery. Pediatrics
#32
JOURNAL ARTICLE
Jia-Shu Chen, William B Harris, Katherine J Wu, H Westley Phillips, Chi-Hong Tseng, Alexander G Weil, Aria Fallah
BACKGROUND AND OBJECTIVES: Hemispheric surgery effectively treats unihemispheric pediatric drug-resistant epilepsy (DRE) by resecting and/or disconnecting the epileptic hemisphere. Modifications to the original anatomic hemispherectomy have generated multiple functionally equivalent, disconnective techniques for performing hemispheric surgery, termed functional hemispherotomy. While a myriad of hemispherotomy variants exist, all of them can be categorized according to the anatomic plane they are performed in, which includes vertical approaches at or near the interhemispheric fissure and lateral approaches at or near the Sylvian fissure...
July 25, 2023: Neurology
#33
JOURNAL ARTICLE
Thilo Kalbhenn, Thomas Cloppenborg, Friedrich G Woermann, Anne Hagemann, Tilman Polster, Roland Coras, Ingmar Blümcke, Christian G Bien, Matthias Simon
OBJECTIVE: Completeness as a predictor of seizure freedom is broadly accepted in epilepsy surgery. We focused on the requirements for a complete hemispherotomy and hypothesized that the disconnection of the insula contributes to a favorable postoperative seizure outcome. We analyzed surgical and non-surgical predictors influencing long-term seizure outcome before and after a modification of our hemispherotomy technique. METHODS: We retrospectively studied surgical procedures, electro-clinical parameters, MRI results, and follow-up data in all children who had undergone hemispherotomy between 2001 and 2018 at our institution...
April 28, 2023: Epilepsia
#34
JOURNAL ARTICLE
Vijay M Ravindra, Lucia Ruggieri, Nisha Gadgil, Angela P Addison, Ilana Patino, David D Gonda, Jason Chu, Laura Whitehead, Anne Anderson, Gloria Diaz-Medina, Kimberly Houck, Akshat Katyayan, Laura Masters, Audrey Nath, Michael Quach, James John Riviello, Elaine Seto, Krystal Elizabeth Sully, Latanya Agurs, Sonali Sen, Maureen Handoko, Rohini Coorg, Irfan Ali, Daniel Ikeda, Howard Weiner, Daniel J Curry
INTRODUCTION: In carefully selected patients with medically refractory epilepsy, disconnective hemispherotomy can result in significant seizure freedom; however, incomplete disconnection can result in ongoing seizures and poses a significant challenge. Completion hemispherotomy provides an opportunity to finish the disconnection. We describe the use of magnetic resonance-guided laser interstitial thermal ablation (MRgLITT) for completion hemispherotomy. METHODS: Patients treated with completion hemispherotomy using MRgLITT at our institution were identified...
2023: Stereotactic and Functional Neurosurgery
#35
JOURNAL ARTICLE
Mark A Damante, Nathan Rosenberg, Ammar Shaikhouni, Hannah K Johnson, Jeffrey W Leonard, Adam P Ostendorf, Jonathan A Pindrik
OBJECTIVE: To compare functional and seizure outcomes in children with vascular and dysplastic etiologies of cerebral palsy (CP) and medically intractable epilepsy (MIE) following functional hemispherotomy (FH) or anatomic hemispherectomy (AH). METHODS: Consecutive patients satisfying inclusion criteria from 07/01/2015 to 12/01/2019 were reviewed for demographic data and seizure (Engel classification) and functional (Functional Independence Measure for Children [WeeFIM]) outcomes...
April 8, 2023: World Neurosurgery
#36
T S Park, Susan Joh, Matthew D Smyth, Nicole L Meyer, Deanna M Walter
Performing a hemispherotomy or hemispherectomy is known to treat medically intractable epilepsy successfully, yet contralateral hemiparesis and increased muscle tone follow the epilepsy surgery. Spasticity and coexisting dystonia presumably cause the increased muscle tone in the lower extremity on the opposite side of epilepsy surgery. However, the extent of the role of spasticity and dystonia in high muscle tone is unknown. A selective dorsal rhizotomy is performed to reduce spasticity. If a selective dorsal rhizotomy is performed in the affected patient and muscle tone is reduced, the high muscle tone is not due to dystonia...
March 2023: Curēus
#37
JOURNAL ARTICLE
Hidenori Sugano, Yasushi Iimura, Hiroharu Suzuki, Takumi Mitsuhashi, Tetsuya Ueda, Kazuki Nishioka, Samantha Tamrakar, Kostadin Karagiozov, Madoka Nakajima
BACKGROUND: Hemispherectomy is an optimal treatment for patients with Sturge-Weber syndrome (SWS) affecting the whole hemisphere; however, a consensus has not been reached regarding therapeutic choices for those with involvement of two to three lobes. In this study, we compared seizure and cognitive outcomes between medical and surgical treatment groups in patients with multilobar involvement. METHODS: We evaluated 50 patients with multilobar involvement. Surgical indications included (1) antiepileptic drug (AED)-resistant seizures; (2) developmental delay; and (3) cortical atrophy...
February 24, 2023: Pediatric Neurology
#38
JOURNAL ARTICLE
Victor M Lu, Shelly Wang, John Ragheb
OBJECTIVE: Hemispherectomy is a complex surgical intervention for medically refractory epilepsy, and its surgical sequelae continue to be defined. The incidence, timing, and predictors of postoperative hydrocephalus are not well understood. Correspondingly, the aim of this study was to define the natural history of the development of hydrocephalus after hemispherectomy based on the authors' institutional experience. METHODS: The authors performed a retrospective review of their departmental database for all relevant cases between 1988 and 2018...
March 17, 2023: Journal of Neurosurgery. Pediatrics
#39
JOURNAL ARTICLE
Jennifer V Gettings, Shatha Shafi, Jennifer Boyd, O Carter Snead, James Rutka, James Drake, Bláthnaid McCoy, Puneet Jain, Robyn Whitney, Cristina Go
Background: Infantile epileptic spasms syndrome is an epileptic encephalopathy, characterized by spasms, hypsarrhythmia, and developmental regression. Appropriately selected patients with infantile epileptic spasms syndrome may be candidates for epilepsy surgery. Methods: This is a single-center retrospective case series of children 0-18 years with a current or previous diagnosis of infantile epileptic spasms syndrome with a lesion on magnetic resonance imaging (MRI) and/or positron emission tomography scan who underwent epilepsy surgery at The Hospital for Sick Children (HSC) in Toronto, Canada...
March 2023: Journal of Child Neurology
#40
JOURNAL ARTICLE
Han Xie, Jiayi Ma, Taoyun Ji, Qingzhu Liu, Lixin Cai, Ye Wu
Vagus nerve stimulation (VNS) is one of the treatment options for drug-resistant epilepsy (DRE). To analyze the efficacy of VNS in children of DRE with structural etiology, we conducted a cohort study including 95 patients of DRE with structural etiology who underwent VNS treatment. Patients were followed up every 3 months at the outpatient department or via a remote programming platform. The median follow-up period was 2.6 years (range 1.0-4.6 years). The respective responder rates at 6, 12, 18, and 24 months of follow-up were 40...
March 2023: Epilepsy & Behavior: E&B
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