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Hemispherotomy

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https://www.readbyqxmd.com/read/28799142/what-to-do-in-failed-hemispherotomy-our-clinical-series-and-review-of-the-literature
#1
REVIEW
Andrea Bartoli, Y El Hassani, B Jenny, S Momjian, C M Korff, M Seeck, S Vulliemoz, K Schaller
Hemispherotomy is an established surgical technique to cure or palliate selected, mostly young patients suffering from refractory epilepsy. However, a few patients continue to have seizures despite the surgical hemispherical disconnection. We present a case series of patients who underwent redo hemispherotomy after a first unsuccessful hemispherical disconnection and provide a roadmap for subsequent workup and treatment. The institutional database of epilepsy surgery was reviewed. Twenty-four patients who underwent hemispherotomies for refractory epilepsy were identified between 2007 and 2016...
August 10, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28637636/epilepsy-after-cerebral-infection-review-of-the-literature-and-the-potential-for-surgery
#2
Georgia Ramantani, Hans Holthausen
The risk of unprovoked seizures in population-based cohorts of cerebral infection survivors is 7-8% in developed countries, rising to considerably higher rates in resource-poor countries. The main risk factors for epilepsy after cerebral infection, besides acute seizures, are infection-associated brain lesions and status epilepticus during the acute phase. Despite the high prevalence of pharmacoresistant epilepsies after cerebral infections, especially in patients with MRI-identifiable lesions, only a small minority undergoes epilepsy surgery...
June 1, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28574317/reoperation-after-failed-resective-epilepsy-surgery-in-children
#3
Osama Muthaffar, Klajdi Puka, Luc Rubinger, Cristina Go, O Carter Snead, James T Rutka, Elysa Widjaja
OBJECTIVE Although epilepsy surgery is an effective treatment option, at least 20%-40% of patients can continue to experience uncontrolled seizures resulting from incomplete resection of the lesion, epileptogenic zone, or secondary epileptogenesis. Reoperation could eliminate or improve seizures. Authors of this study evaluated outcomes following reoperation in a pediatric population. METHODS A retrospective single-center analysis of all patients who had undergone resective epilepsy surgery in the period from 2001 to 2013 was performed...
August 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28424599/electrophysiological-sequelae-of-hemispherotomy-in-ipsilateral-human-cortex
#4
Ammar H Hawasli, Ravi Chacko, Nicholas P Szrama, David T Bundy, Mrinal Pahwa, Chester K Yarbrough, Brian J Dlouhy, David D Limbrick, Dennis L Barbour, Matthew D Smyth, Eric C Leuthardt
Objectives: Hemispheric disconnection has been used as a treatment of medically refractory epilepsy and evolved from anatomic hemispherectomy to functional hemispherectomies to hemispherotomies. The hemispherotomy procedure involves disconnection of an entire hemisphere with limited tissue resection and is reserved for medically-refractory epilepsy due to diffuse hemispheric disease. Although it is thought to be effective by preventing seizures from spreading to the contralateral hemisphere, the electrophysiological effects of a hemispherotomy on the ipsilateral hemisphere remain poorly defined...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28386929/extratemporal-disconnective-procedures-for-the-treatment-of-epilepsy-in-children
#5
Marcelo Volpon Santos, Hélio Rubens Machado
Surgical treatment of epilepsy in children often involves brain areas outside the temporal lobe and, therefore, techniques for extratemporal surgery must be included in the armamentarium of epilepsy surgery centers. Nowadays, disconnective procedures are preferable to traditional resective operations because they reduce the rate of complications related to extensive resections while achieving equivalent seizure outcomes. This article describes the practical anatomy and surgical techniques used for temporoparietooccipital (TPO), parietooccipital, and frontal disconnections, as well as the possibility of extending previous lobar disconnections to the whole hemisphere (hemispherotomy)...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28386922/technical-descriptions-of-four-hemispherectomy-approaches-from-the-pediatric-epilepsy-surgery-meeting-at-gothenburg-2014
#6
REVIEW
James E Baumgartner, Jeffrey P Blount, Thomas Blauwblomme, P Sarat Chandra
Hemispherectomy is a complex multistep procedure with a steep learning curve. Several surgical approaches have been developed, but each requires considerable practice to master. Four experienced pediatric neurosurgeons, who participated in the 2014 Gothenburg Pediatric Epilepsy Surgery Meeting, provided succinct technical summaries of four hemispherectomy approaches: modified functional hemispherectomy, peri-insular hemispherotomy, parasagittal hemispherotomy, and endoscopic-assisted hemispherotomy. No clinical or outcome data are included...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28348960/delayed-diagnosis-of-shunt-overdrainage-following-functional-hemispherotomy-and-ventriculoperitoneal-shunt-placement-in-a-hemimegalencephaly-patient
#7
Yasunori Nagahama, David Peters, Sho Kumonda, Adam Vesole, Charuta Joshi, Brian J Dlouhy, Hiroto Kawasaki
Shunt overdrainage represents a nebulous condition of variable clinical and imaging presentations, where the diagnosis is primarily clinical. The condition presents a diagnostic challenge particularly in patients with cognitive impairment and developmental delays. Here we present a 3-year-old boy with drug-resistant focal onset seizures due to hemimegalencephaly who previously underwent functional hemispherotomy followed by ventriculoperitoneal shunt placement for postoperative hydrocephalus. The subsequent clinical course was complicated by delayed diagnosis of shunt overdrainage in the absence of significant image findings...
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/28239546/functional-hemispherotomy-in-rasmussen-syndrome-in-the-absence-of-classic-mri-findings
#8
Yasunori Nagahama, Charuta Joshi, Brian Dlouhy, Angela Y Wu, Taylor J Abel, Gary Baumbach, Hiroto Kawasaki
A 7-year-old previously healthy girl presented with a left-sided focal seizure without impaired consciousness and subsequently developed epilepsia partialis continua. Initial MRI was normal, and the subsequent images only showed a focal T2/FLAIR hyperintense area without cortical atrophy. She was diagnosed with Rasmussen syndrome by pathology and promptly treated with functional hemispherotomy. Rasmussen syndrome is a rare progressive neurological disorder, the only definitive cure for which is hemispheric disconnection...
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/28236728/language-plasticity-after-hemispherotomy-of-the-dominant-hemisphere-in-3-patients-implication-of-non-linguistic-networks
#9
Christine Bulteau, Isabelle Jambaqué, Catherine Chiron, Sebastian Rodrigo, Georg Dorfmüller, Olivier Dulac, Lucie Hertz-Pannier, Marion Noulhiane
The neural networks involved in language recovery following hemispherotomy of the dominant hemisphere after language acquisition in children remain poorly known. Twelve hemispherotomized children (mean age at surgery: 11.3years) with comparable post-operative neuropsychological patterns underwent multi-task language functional MRI. Three of them had recovered from an initial postoperative aphasia i.e., hemispherotomy was performed on the language-dominant hemisphere. Our main results revealed (1) perisylvian activations in all patients after either left or right hemispherotomy; (2) no differences in activations between groups regarding the side of hemispherotomy; (3) additional activations in pre-frontal (3/3) and hippocampal/parahippocampal and occipito-parietal (2/3) areas, when comparing language activation in each of the three subjects with hemispherotomy of the language-dominant hemisphere to the group of 9 non-dominant hemispherotomized patients...
April 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/27791702/hemispherotomy-in-children-with-electrical-status-epilepticus-of-sleep
#10
Anna Jeong, Jennifer Strahle, Ananth K Vellimana, David D Limbrick, Matthew D Smyth, Mary Bertrand
OBJECTIVE Electrical status epilepticus of sleep (ESES) is a rare electrographic pattern associated with global regression, which is often poorly responsive to traditional epilepsy treatments and can have a devastating and permanent neurocognitive outcome. The authors analyzed clinical, electroencephalographic, and neuropsychological outcomes in 9 patients with refractory ESES treated with functional hemispherotomy to illustrate the wide clinical spectrum associated with the disease and explore the role of hemispherotomy in its treatment...
January 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27652010/vertical-parasagittal-hemispherotomy-for-sturge-weber-syndrome-in-early-infancy-case-report-and-literature-review
#11
Xiangyu Liu, Taisuke Otsuki, Akio Takahashi, Takanobu Kaido
INTRODUCTION: The authors here present a rare case of a 3-month-old infant with unilateral Sturge-Weber syndrome (SWS) who had excellent seizure control and no aggravation of previous existed neurological deficits after vertical parasagittal hemispherotomy (VPH). To our knowledge, this patient with SWS was the youngest one who received VPH. CASE DESCRIPTION: The use of VPH results in a successful treatment of intractable epilepsy in a patient with seizure onset in early infancy...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27611898/presurgical-evaluation-of-pediatric-epilepsy-patients-prior-to-hemispherotomy-the-prognostic-value-of-18-f-fdg-pet
#12
Tatjana Traub-Weidinger, Philip Weidinger, Gundrun Gröppel, Georgios Karanikas, Wolfgang Wadsak, Gregor Kasprian, Christian Dorfer, Anastasia Dressler, Angelika Muehlebner, Marcus Hacker, Thomas Czech, Martha Feucht
OBJECTIVE The objective of this study was to investigate whether fluorine-18 fluorodeoxyglucose PET ((18)F-FDG PET) can help to predict seizure outcome after hemispherotomy and therefore may be useful in decision making and patient selection. METHODS Children and adolescents less than 18 years of age who underwent (18)F-FDG PET studies during presurgical evaluation prior to hemispherotomy and had follow-up data of at least 12 months after surgery were included. Seizure outcome was classified according to the recommendations of the International League Against Epilepsy...
December 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27558205/immediate-termination-of-electrical-status-epilepticus-in-sleep-after-hemispherotomy-is-associated-with-significant-progress-in-language-development
#13
Gudrun Gröppel, Christian Dorfer, Anastasia Dressler, Angelika Mühlebner, Barbara Porsche, Johann A Hainfellner, Thomas Czech, Martha Feucht
AIM: To study the effect of hemispherotomy on electrical status epilepticus in sleep (ESES) and language development. METHOD: Children with a confirmed diagnosis of ESES prior to surgery and a minimum of 24 months of developmental follow-up data were compared with age-matched controls without ESES. Language quotients (LQs) were calculated before and after surgery. RESULTS: Eleven patients (five females, six males) and 21 controls (11 females, 10 males) were included...
January 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/27453818/successful-hemispherotomy-for-a-patient-with-intractable-epilepsy-secondary-to-bilateral-congenital-brain-malformation-with-lateralized-pyramidal-tract-of-diffusion-tensor-image-tractography
#14
Yuri Nagai, Ayataka Fujimoto, Tohru Okanishi, Hironao Motoi, Sotaro Kanai, Takuya Yokota, Hideo Enoki, Mitsuyo Nishimura, Takamichi Yamamoto
PURPOSE: To perform an epilepsy surgery on a patient with drug resistant epilepsy secondary to bilateral brain malformation. The patient was a 2-year 9-month-old boy who had congenital bilateral multiple abnormalities. He developed a complex partial seizure at 9 months old. Based on the presurgical evaluations, he underwent a right hemispherotomy. RESULTS: Brain MRI revealed congenital bilateral polymicrogyria, right schizencephaly, and corpus callosum agenesis...
2016: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/27391919/use-of-a-contoured-bioresorbable-plate-with-a-hemostatic-plug-to-control-life-threatening-bleeding-from-the-superior-sagittal-sinus-during-hemispherotomy-technical-note
#15
Gerald F Tuite, Carolyn M Carey, William W Nelson, Scott J Raffa, S Parrish Winesett
Profuse bleeding originating from an injured cerebral sinus can be a harrowing experience for any surgeon, particularly during an operation on a young child. Common surgical remedies include sinus ligation, primary repair, placement of a hemostatic plug, and patch or venous grafting that may require temporary stenting. In this paper the authors describe the use of a contoured bioresorbable plate to hold a hemostatic plug in place along a tear in the inferomedial portion of a relatively inaccessible part of the posterior segment of the superior sagittal sinus in an 11-kg infant undergoing hemispherotomy for epilepsy...
October 2016: Journal of Neurosurgery. Pediatrics
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/27296534/-hemispherectomy-in-the-treatment-of-pediatric-symptomatic-epilepsy-of-children
#17
A G Melikyan, Yu V Kushel', A N Vorob'ev, N A Arkhipova, V S Sorokin, N V Lemeneva, I A Savin, I N Pronin, A B Kozlova, O A Grinenko, S B Buklina, I A Nagorskaya
INTRODUCTION AND PURPOSE: Hemispherectomy is a recognized option in the treatment of symptomatic forms of intractable focal epilepsy in patients with developmental brain malformations and some acquired lesions of one the hemispheres. The prognosis for an outcome of the technique is important in terms of the indications for surgical treatment. MATERIAL AND METHODS: We described the hemispherectomy technique and its variants and analyzed our own experience of surgery in 40 children...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27176878/parental-experiences-before-and-long-term-after-their-children-s-hemispherotomy-a-population-based-qualitative-study
#18
Anneli Ozanne, Cecilia Verdinelli, Ingrid Olsson, Ulla H Graneheim, Kristina Malmgren
Severe childhood epilepsy has an impact on the whole family. For selected children, hemispherotomy is the treatment of choice. The aim of this study was to explore parents' experiences before and after hemispherotomy as reported at a long-term follow-up and their view on received information and support. This was a population-based qualitative descriptive study, using qualitative content analysis of interviews. Seven to eighteen years after hemispherotomy, parents of twenty-one operated children were interviewed about the family life situation, expectations before surgery, and support and information before and after surgery...
July 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/27106864/anti-tumor-necrosis-factor-alpha-therapy-adalimumab-in-rasmussen-s-encephalitis-an-open-pilot-study
#19
Stanislas Lagarde, Nathalie Villeneuve, Agnès Trébuchon, Elsa Kaphan, Anne Lepine, Aileen McGonigal, Agathe Roubertie, Marie-Anne J Barthez, Valérie Trommsdorff, Jérémie Lefranc, Samer Wehbi, Vincent des Portes, Virginie Laguitton, Pierre Quartier, Didier Scavarda, Bernard Giusiano, Mathieu Milh, Christine Bulteau, Fabrice Bartolomei
OBJECTIVE: Rasmussen's encephalitis (RE) is a severe chronic inflammatory brain disease affecting one cerebral hemisphere and leading to drug-resistant epilepsy, progressive neurologic deficit, and unilateral brain atrophy. Hemispherotomy remains the gold standard treatment but causes permanent functional impairment. No standardized medical treatment protocol currently exists for patients prior to indication of hemispherotomy, although some immunotherapies have shown partial efficacy with functional preservation but poor antiseizure effect...
June 2016: Epilepsia
https://www.readbyqxmd.com/read/27106840/outcomes-of-multilobar-resections-for-epilepsy-in-sweden-1990-2013-a-national-population-based-study
#20
Daniel T Nilsson, Kristina Malmgren, Roland Flink, Bertil Rydenhag
BACKGROUND: Reports on outcome after multilobar resection (MLR) are scarce and most are retrospective single-centre studies or case studies with few patients. The aim of this study is to present seizure and complication outcomes 2 years after MLR in a prospective population-based series. METHOD: The Swedish National Epilepsy Surgery Registry (SNESUR) provides prospective population-based data on outcome and complications after epilepsy surgery. For this study, we have analysed data on seizure outcome and complications after MLR from the SNESUR between 1990 and 2013...
June 2016: Acta Neurochirurgica
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