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Hemispherotomy

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https://www.readbyqxmd.com/read/29550191/successful-hemispherotomy-in-two-refractory-epilepsy-patients-with-cerebral-hemiatrophy-and-contralateral-eeg-abnormalities
#1
Rumiko Takayama, Katsumi Imai, Hiroko Ikeda, Koichi Baba, Naotaka Usui, Yukitoshi Takahashi, Yushi Inoue
We describe two cases of refractory epilepsy with cerebral hemiatrophy and contralateral electroencephalographic (EEG) abnormalities, in which hemispherotomy of the atrophic hemisphere effectively controlled seizures. Case 1 was a 5-year-1-month-old girl with refractory bilateral asymmetrical tonic posturing seizures predominantly in the right arm. Magnetic resonance imaging showed left porencephaly corresponding to a left middle cerebral artery infarction. Case 2 was a 3-year-8-month-old boy with refractory bilateral asymmetrical tonic posturing seizures predominantly in the right arm due to atrophy of the left cerebral hemisphere after septic meningitis...
March 14, 2018: Brain & Development
https://www.readbyqxmd.com/read/29525400/safety-and-effectiveness-of-surgery-for-epilepsy-in-children-experience-of-a-tertiary-hospital-in-ecuador
#2
O Fernández-Concepción, M López Jiménez, C Valencia-Calderón, A Calderón-Valdivieso, A Recasén-Linares, L Reyes-Haro, C Vásquez-Ham
INTRODUCTION: There is sufficient evidence on the usefulness of surgery as a therapeutic alternative for patients with drug-resistant epilepsy; however this treatment is underutilized, especially in developing countries. METHODS: We describe the outcomes of epilepsy surgery in 27 paediatric patients at Hospital Baca Ortiz in Quito, Ecuador. Our analysis considered the following variables: reduction in seizure frequency, surgery outcome according to the Engel classification, improvement in quality of life, and serious complications due to surgery...
March 7, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29480510/-functional-hemispherectomy-long-term-follow-up-in-a-series-of-five-patients
#3
X Rodriguez-Osorio, F J Lopez-Gonzalez, J Eiris-Punal, C Frieiro-Dantas, C Gomez-Lado, M Peleteiro-Fernandez, A Prieto-Gonzalez
INTRODUCTION: Functional hemispherectomy consists in palliative epilepsy surgical procedure usually performed in patients with pharmaco-resistant epilepsy and hemispheric syndromes. It is based on the neural disconnection of the affected hemisphere with preservation of the vascular supply. AIM: To analyze long-term prognosis and safety of the hemispherectomies performed in our institution. PATIENTS AND METHODS: Retrospective analysis collecting the following variables: age, gender, age of epilepsy onset, type of seizures, etiology, age of epilepsy surgery, prognosis and potential surgical complications...
March 1, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29459061/hemiconvulsion-hemiplegia-epilepsy-evolving-to-contralateral-hemi-lennox-gastaut-like-phenotype
#4
Kenneth A Myers, Ingrid E Scheffer, John S Archer
BACKGROUND: Hemiconvulsion-hemiplegia-epilepsy (HHE) involves infantile-onset acute hemiconvulsive febrile status epilepticus with subsequent unilateral cerebral atrophy and hemiparesis. Chronic epilepsy later develops, typically involving refractory focal seizures; however, the underlying pathophysiology of this epilepsy is not well understood. PATIENT: We present a boy who had a typical acute presentation of HHE at 23 months, but an unusual evolution to chronic epilepsy in which the initially unaffected hemisphere was significantly abnormal...
February 16, 2018: Brain & Development
https://www.readbyqxmd.com/read/29059488/stereoelectroencephalography-and-surgical-outcome-in-polymicrogyria-related-epilepsy-a-multicentric-study
#5
MULTICENTER STUDY
Louis Georges Maillard, Laura Tassi, Fabrice Bartolomei, Hélène Catenoix, François Dubeau, William Szurhaj, Philippe Kahane, Anca Nica, Petr Marusic, Ioana Mindruta, Francine Chassoux, Georgia Ramantani
OBJECTIVE: We aimed to (1) assess the concordance between various polymicrogyria (PMG) types and the associated epileptogenic zone (EZ), as defined by stereoelectroencephalography (SEEG), and (2) determine the postsurgical seizure outcome in PMG-related drug-resistant epilepsy. METHODS: We retrospectively analyzed 58 cases: 49 had SEEG and 39 corticectomy or hemispherotomy. RESULTS: Mean age at SEEG or surgery was 28.3 years (range, 2-50)...
November 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29054955/trapped-ipsilateral-lateral-ventricle-a-delayed-complication-of-hemispherotomy-for-rasmussen-s-encephalitis
#6
Rajesh Shankar Iyer, Ravi Mohan Rao, Karunakaran Muthukalathi, Praveen Kumar
Hemispherotomy is the currently preferred surgical treatment option for refractory unihemispheric epilepsies. The incidence of hydrocephalus is greatly reduced in this disconnective procedure when compared with the resective procedure of anatomical hemispherectomy. We describe the occurrence of ipsilateral trapped lateral ventricle months after hemispherotomy for Rasmussen's encephalitis. There is enough evidence to suggest that this rare and interesting complication is due to the local inflammatory changes associated with the surgical trauma...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28938499/postherpetic-anti-n-methyl-d-aspartate-receptor-encephalitis-after-hemispherotomy-in-a-patient-with-intractable-startle-epilepsy
#7
Irem Erkent, Rahsan Gocmen, F Irsel Tezer, Kader K Oguz, Nalan Kucuksahin, Figen Soylemezoglu, Burcak Bilginer, Serap Saygi
Herpes simplex encephalitis (HSE) has been increasingly reported after neurosurgical procedures, mostly after tumor resections in patients with a prior history of HSE. Early detection and appropriate treatment are essential to prevent high mortality of the disease; however, there are diagnostic difficulties due to nonspecific prodromal symptoms. In addition, anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis has been reported after HSE as an immunological relapse. Here, we report a case of postherpetic anti-NMDAR encephalitis following right hemispherotomy for intractable startle-induced seizures, to emphasize the importance of early diagnosis and appropriate treatment...
February 2018: Neuropediatrics
https://www.readbyqxmd.com/read/28891483/emergency-surgery-for-refractory-status-epilepticus
#8
Abhijeet Botre, Vrajesh Udani, Neelu Desai, Spoorthy Jagadish, Milind Sankhe
BACKGROUND: Management of refractory status epilepticus in children is extremely challenging. CASE CHARACTERISTICS: Two children with medically refractory status epilepticus, both of whom had lesional pathology on MRI and concordant data on EEG and PET scan. INTERVENTION: Emergency hemispherotomy performed in both patients. A complete, sustained seizure freedom obtained postoperatively. MESSAGE: Emergency surgery is a treatment option in selected cases of drug refractory status epilepticus with lesional pathology and concordant data...
August 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28890033/the-wada-test-might-predict-postoperative-fine-finger-motor-deficit-after-hemispherotomy
#9
Ayataka Fujimoto, Tohru Okanishi, Mitsuyo Nishimura, Sotaro Kanai, Keishiro Sato, Hideo Enoki
INTRODUCTION: Cerebral hemispherotomy is a surgical method with a high rate of seizure reduction in patients with intractable epilepsy. However, there is a probability of postoperative motor deficits. The objective of this study was to investigate whether the Wada test can help predict motor function outcomes after hemispherotomy and, therefore, may be useful in decision-making and patient selection. PATIENTS AND METHOD: A total of 13 patients with hemispherical intractable epilepsy underwent hemispherical disconnection surgeries...
November 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28853521/-hemispherotomy-for-treatment-of-refractory-epilepsy-in-children
#10
Jonathan Roth, Sari Nagar, Shlomi Constantini, Itzhak Fried
INTRODUCTION: Hemispherotomies are an extreme treatment for epilepsy. As opposed to focal resections, in hemispherotomies the entire hemisphere is disconnected from the remaining nervous system, including functional regions and fibers. Despite this, hemispherotomy is recommended for certain indications, with good epilepsy and functional outcomes. AIMS: To summarize the experience of hemispherotomy performed at a tertiary national center. METHODS: A retrospective study was conducted including all patients operated on between 2001 and 2014...
August 2017: Harefuah
https://www.readbyqxmd.com/read/28799142/what-to-do-in-failed-hemispherotomy-our-clinical-series-and-review-of-the-literature
#11
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...
January 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/28637636/epilepsy-after-cerebral-infection-review-of-the-literature-and-the-potential-for-surgery
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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